Residents are scored on the individual milestones using a 5 point ENTRUSTMENT SCALE. Per the ACGME, residents must score a 3.5 or greater by the end of their residency in order to graduate.
Entrustment Scale Scoring
1 = Resident cannot consistently perform this skill, even with assistance.
2 = Resident can perform this skill but only under direct (i.e. physically present or immediately available) supervision by a more senior member of the team
3 = Resident can perform this skill with indirect supervision (i.e. immediately available by phone or senior member checking after completed).
4 = Can do this at the level of a general IM attending
5 = Expert, advanced skill beyond that of general IM attending.
UNDERSTANDING EVALUATIONS AND PROGRESSION
ACGME Educational Competencies
Residents are evaluated on multiple milestones in six different categories, as defined by the ACGME.
Residents must demonstrate a commitment to professionalism and an adherence to ethical principles
Patient Care and Procedural Skills
Residents must be able to provide patient care that is patient- and family-centered, compassionate, equitable, appropriate, and effective for the treatment of health problems and the promotion of health. Residents must be able to perform all medical, diagnostic, and surgical procedures considered essential for the area of practice.
Residents must demonstrate knowledge of established and evolving biomedical, clinical, epidemiological, and socialbehavioral sciences, including scientific inquiry, as well as the application of this knowledge to patient care.
Practice-based Learning and Improvement
Residents must demonstrate the ability to investigate and evaluate their care of patients, to appraise and assimilate scientific evidence, and to continuously improve patient care based on constant self-evaluation and lifelong learning.
Interpersonal and Communication
Skills Residents must demonstrate interpersonal and communication skills that result in the effective exchange of information and collaboration with patients, their families, and health professionals. Residents must learn to communicate with patients and patients’ families to partner with them to assess their care goals, including, when appropriate, end-oflife goals.
Residents must demonstrate an awareness of and responsiveness to the larger context and system of health care, including the structural and social determinants of health, as well as the ability to call effectively on other resources to provide optimal health care. Residents must learn to advocate for patients within the health care system to achieve the patient's and patient’s family's care goals, including, when appropriate, end-of-life goals
Assessments are tools used by the program to evaluate a resident's progress toward each Milestone
Intraining Exam scores
Continuity clinic evals
End-of-the-Month rotation evals
Targeted Direct Observation
Assessments are used by the CCC to generate a semi-annual "Milestone Report" which is required by the ACGME. This report assigns a resident a numeric score in each of the Milestones, utilizing the entrustment scale.
Who is the CCC composed of?
Associate Program Directors
The CCC Meets monthly, reviews all resident tiles at least twice per year. All proceedings are confidential.
Clinical Competency Committee (CCC)
Is available for review at any time on New Innovations>>Portfolio>>My Reviews.
Your Milestone Report
Mentorship comes in many forms in our program. Mentorship opportunities include:
CCC APD Advisor
Every resident's progress is reviewed at least twice a year by the CCC. Each resident is assigned a CCC APD Advisor who will be the one reviewing them over time and meeting individually as needed to discuss specific feedback that has been evident from the CCC review. In addition, issues regarding individual residents may be referred through a variety of ways and include but are not limited to academic progress, professionalism issues, patient care concerns, or moral and ethical behavior. These concerns are discussed in a confidential manner and then discussed with the resident. In some instances it may be necessary to have the resident attend the meeting in person in order to set common coals and objects between the individual and the advisor.
A faculty mentor is any faculty member of your choice with whom you feel comfortable addressing your professional goals (e.g. cardiology faculty to help you with your goal of getting a position as a cardiology fellow) Your faculty mentor will help you develop your portfolio and other professional development. This may or may not be the same person as your coach
What you can do to influence your milestone report
Get the most out of the curriculum provided Set Goals! Get input from your evaluations, your observation of peers and role models, and your own personal aspirations. Be accountable to yourself regarding your progress toward these goals. Meet with your coach or informal mentors, and discuss the change you want to see.