ACGME Milestones/CCC. Content ACGME 3/9/2015. By the end of this session, the learner will be able to:

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Priscilla Benson
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ACGME Milestones/CCC A McLaren MD Banner

administrative conflicts of interest related to

of this session, the learner will be able to:

for CCCs Discuss the challenges in keeping faculty

process Content Reliable learning resources What

Education of faculty and residents Systems

Review/Legal Evaluation software ACGME http://www.

1 ACGME Milestones/CCC A McLaren MD Banner Orthopaedic Residency Disclosures no monetary or administrative conflicts of interest related to this program or presentation Phoenix AZ By the end of this session, the learner will be able to: Discuss the use of management systems to prepare for CCCs Discuss the challenges in keeping faculty on track Identify potential changes to improve the process Content Reliable learning resources What is a CCC? What are milestones? Education of faculty and residents Systems interactions Policies, Contracts, Peer Review/Legal Evaluation software ACGME x 1

2 A White MD. Washington University. Pediatrics Residency Accreditation Council for Graduate Medical Education (ACGME) 2

[a]milestone = a Biopsy do not represent

3 [a]milestone = a Biopsy do not represent the totality of any discipline, a robust foundational core. intended to be used as a formative framework to guide curricula, expectations, assessment, and CCC deliberations in programs. ultimately guide and inform CCC deliberations lead to a summative judgment resident s promotion and graduation should not be used as the sole criteria for promotion or graduation 3

4 [all]milestones = a Discipline MUST NOT teach to [some] Milestones inventory where milestones are taught identify gaps in curriculum iteratively refine the curriculum Milestones are used collectively to evaluate a program specific Milestones are not validated not yet used to evaluate a resident Clinical Competency Committee (CCC) ACGME required body to advise the program Director Three or more members of the active teaching faculty No residents Preferably not the PD or Dept. Chair Recues mentors and advisors from conflicted discussions Review the progression of all residents in the program At least biannually Does not make decisions Resident remediation, discipline or progression Program coordinator is not a member Data management, data upload, minutes, logistics sub-cccs large programs where CCC would be too large for meaningful participation of all members complex curricula experts in focused areas of training PGY, motor skills, similar standards and procedures Performance Assessments multiple assessments multiple trained assessors multiple assessment tools CCC synthesizes a consensus one time snapshot >>> performance trend Resident Management Systems Customize Evaluation Forms for Milestones tabulation and archive program and resident analysis average +/- SD dashboard spider graph RMS do not provide human judgment & discussion Policies and Contracts Are any changes in your progressions, graduation or terms of appointment necessary to reflect Milestone reporting to the ACGME? 1. graduate but substantially below Milestones Performance 2. NOT graduate while substantially at or above Milestones Performance 4

5 Interactions with other ACGME Requirements 1. Annual Program Evaluation and Improvement (PEC) 2. Faculty Development Faculty Development Educators need to understand key elements of assessment information they contribute the data assessment methods and tools purpose of the curricular experience they are supervising Faculty Development Leaders need to understand the whole that is considered in reviewing performance and CCC mandate the program director duties Interactive Spread Sheet 1 2Bingha 1 Hustedt 1 Palsis 1 Patel Richardso 2Goltzer 2Hosack 2Roberts 3Fraser 3Klempf 3Swanso 4 4Abildga 5Harmse 5Patterso 5Waldro 3Wood 4Jarbp 4Odgers 4Schmidt Cumming m n ard n n p n ham Hip Knee OA 25 Jr st st+ st+ Jr Jr Sr Jr Sr Sr Jr Jr Sr Gr Sr Gr Sr Gr Gr Gr Ankle Arthritis 9 Jr st st st+ Jr Jr Sr Jr Jr Jr Jr Jr Gr Sr+ Gr Jr Sr Sr+ Gr Gr Carpal Tunnel 13 Jr+ st+ st+ st+ st Jr Jr+ Jr Gr Jr Jr Jr Gr Gr Gr Gr Jr Gr Gr Gr Metastatic Lesion 29 Jr st st st+ Jr st Sr Jr Sr Jr+ Sr Jr Sr Gr Sr Gr Sr Gr Gr Gr Septic Hip 35 Jr st st st+ Jr st Jr+ Jr Jr Jr Sr Jr Sr+ Gr+ Sr+ Gr Gr Gr Gr Gr Supracondylar Humerus Fracture 39 Jr st st st+ st st Jr Jr Sr Jr+ Jr Jr Sr Gr Sr Gr Gr Gr Gr Gr Rotator Cuff 37 Jr st st+ Jr Jr st+ Jr Jr Gr Jr+ Jr Jr Sr Gr Sr Sr Sr Gr Gr Gr Degen Spine 15 Jr+ st st st Jr Jr Sr Jr Sr Jr Sr Jr Jr+ Gr Jr+ Gr+ Jr Gr Gr Gr ACL 7 Jr st st st st Jr Jr+ Jr Sr Jr+ Jr Jr Sr Gr Sr Gr Sr Gr Gr Gr Meniscal Tear 33 Jr st st Jr st Jr Jr+ Jr Sr Jr+ Jr Jr Sr Gr Sr Gr Gr Gr Gr+ Gr Adult Elbow Fracture 23 Jr st st st Jr Jr Jr Jr Jr Jr Jr Jr Sr Sr+ Sr Jr+ Sr Gr Gr Gr Ankle Fracture 11 Jr+ st+ st Jr Jr Jr Sr Jr Sr Jr+ Sr Jr+ Sr Gr Sr Jr+ Gr Gr Gr Gr Diabetic Foot 17 Jr+ st st+ st Jr Jr Jr Jr Jr Jr Sr Jr Sr Sr+ Sr Sr Sr Gr Gr Gr Jr+ st st Jr Jr Jr Sr Jr Sr Jr+ Sr Jr Sr Gr Sr Sr Sr Gr Gr Gr Diaphyseal Femur and Tibia Fracture 19 Distal Radius Fracture 21 Jr st st st Jr Jr Sr Jr Sr Jr+ Jr Jr Sr Gr Sr Sr Sr Gr Gr Gr Hip Fracture 27 Jr+ st st st Jr+ Jr Sr Jr Gr Jr+ Sr Jr+ Sr Gr Sr Gr Gr Gr Gr Gr Hip Knee OA 26 Jr+ st st Jr Jr Jr Jr+ Jr Sr Sr Jr Jr Sr Gr Sr Gr Sr Gr Gr Gr Ankle Arthritis 10 Jr+ st st Jr Jr Jr Jr+ st st st+ Jr Jr Gr Sr+ Gr Jr Sr Gr Sr+ Gr Carpal Tunnel 14 Jr+ st+ st+ st+ st st+ Jr+ Jr Gr Jr Jr st Gr Gr Gr Gr Jr Gr+ Gr+ Gr Metastatic Lesion 30 Jr st st st+ Jr st Jr+ Jr Sr Jr+ Sr Jr Sr Sr+ Sr Sr Sr Gr Gr Gr Septic Hip 36 Jr st st st+ st st Jr+ st Jr Jr+ Sr st Sr+ Gr Sr+ Gr Gr Gr Gr Gr Supracondylar Humerus Fracture 41 Jr st st st+ st st st+ Jr Sr Jr+ Jr st Sr Gr Sr Gr Gr Gr+ Gr Gr Rotator Cuff 38 Jr st st Jr Jr st st+ st Sr Jr+ Jr Jr Sr Sr+ Sr Jr Sr Gr Sr+ Gr Degen Spine 16 Jr+ st st st st st+ Jr Jr Jr st+ Sr st Jr+ Gr Jr+ Gr Jr Sr+ Gr Gr ACL 8 Jr st st Jr st st Jr Jr Sr Jr Jr Jr Sr Sr+ Sr Gr Sr Gr Gr Gr Meniscal Tear 34 Jr st st Jr st st Jr Jr Sr Jr Jr Jr Sr Gr Sr Gr Gr Gr+ Gr Gr Adult Elbow Fracture 24 Jr st st st st Jr Jr Jr Jr Jr Jr Jr Sr Sr Sr Jr+ Sr Gr Gr Gr Ankle Fracture 12 Jr+ st st st Jr Jr Jr+ Jr Jr Jr Jr Jr+ Sr Gr Sr Jr+ Gr Gr Gr Gr Diabetic Foot 18 Jr+ st st st Jr Jr st+ Jr Jr Jr Sr Jr Sr Sr+ Sr Jr Sr Sr+ Sr+ Gr Jr+ st st st Jr Jr Jr+ Jr Sr Jr+ Sr Jr Sr Sr+ Sr Sr Sr Gr+ Gr Gr Diaphyseal Femur and Tibia Fracture 20 Distal Radius Fracture 22 Jr st st st Jr Jr Jr+ Jr Sr Jr Jr Jr Sr Gr Sr Sr Sr Gr Gr Gr Hip Fracture 28 Jr+ st st st Jr Jr Jr+ Jr Gr Jr+ Sr Jr+ Sr Sr+ Sr Gr Gr Gr+ Gr+ Gr Compassion Integrity Respect 43 Sr Jr Jr Jr Fac Jr Sr+ Sr Gr Sr Gr Jr Gr Fac Gr Gr Sr Gr Gr+ Gr Accountability 44 Sr Jr Jr Jr Fac Jr Sr+ Sr Gr Sr Jr Jr Gr Gr Gr Gr Gr Gr Gr Gr Self-Directed Learning 45 Sr st+ Jr Jr Gr Jr Gr Jr Gr Jr+ Jr st+ Gr Gr Gr Gr Sr Gr Gr Gr Evidence Based Medicine 46 Sr st+ st Jr Sr Jr Sr Jr Gr Jr+ Jr Jr Gr Gr Gr Gr Sr Gr Gr Gr Systems Thinking 47 Jr+ st+ st st Sr Jr Jr Jr Fac Sr Sr st+ Gr Gr Gr Gr Sr Gr Gr Gr Interprofessional Patient Safety 48a Sr st+ Jr st Fac Jr Jr Jr Gr Sr Sr Jr Gr Gr Gr Sr Sr Gr Gr Gr EHR 48b Sr st+ Jr st Gr Jr Sr+ Jr Fac Sr Sr Jr Gr Sr Gr Gr Sr Gr Gr Gr Communication 49 Sr Jr Jr st Gr Jr Sr+ Sr Gr Sr Jr st+ Gr Fac Gr Sr Sr Gr Gr Gr Teamwork 50 Sr Jr Jr st Fac Sr Gr Sr Gr Sr Sr Jr Gr Gr+ Gr Jr+ Sr Gr Gr Gr 0 Review Process Faculty evaluators none have a complete view of any resident CCC - data synthesis consensus, consistency and continuity across institution and sub-specialty Residents self evaluation PD facilitator (evaluations and CCC) educator (CCC] assesses when not yet rotated feedback Evaluator ISSUES FULL detail across 41 milestones is overwhelming Education [private practice] faculty teaching is satisfaction already do evals+++ Facilitation 5

6 Milestones Levels Level 1: The resident demonstrates milestones expected of an incoming resident. Level 2: The resident is advancing and demonstrates additional milestones, but is not yet performing at a mid-residency level. Level 3: The resident continues to advance and demonstrate additional milestones, consistently including the majority of milestones targeted for residency. Level 4: The resident has advanced so that he or she now substantially demonstrates the milestones targeted for residency. This level is designed as the graduation target. Level 5: The resident has advanced beyond performance targets set for residency and is demonstrating aspirational goals which might describe the performance of someone who has been in practice for several years. It is expected that only a few exceptional residents will reach this level. Education simplify explain it to me like I m a 6 year old distil each level to one simple point one-on-one tutoring for faculty on GoToMeeting at time of evaluations group meeting and information failed one-on-all discussion for residents Milestones Levels (9) Level 1: The resident demonstrates milestones expected of an incoming resident. + Level 2: The resident is advancing and demonstrates additional milestones, but is not yet performing at a mid-residency level. + Level 3: The resident continues to advance and demonstrate additional milestones, consistently including the majority of milestones targeted for residency. + Level 4: The resident has advanced so that he or she now substantially demonstrates the milestones targeted for residency. This level is designed as the graduation target. + Level 5: The resident has advanced beyond performance targets set for residency and is demonstrating aspirational goals which might describe the performance of someone who has been in practice for several years. It is expected that only a few exceptional residents will reach this level. Abbreviated Levels 1. incoming resident not yet mid- level majority of milestones for residency substantially. the graduation target beyond residency, in practice Familiar Levels 1. Student Junior Senior Graduate Faculty preconceived definitions the solution = iterative experiential learning 6

Resudent 1 1 1 1 2 2 2 2 3 3 3 3 4 4 4 4 4 5 5 5 Hip Knee OA 25 Jr st st+ st+ Jr Jr Sr Jr Sr Sr Jr Jr Sr Gr Sr Gr Sr Gr Gr Gr Hip Knee OA 26 Jr+ st st Jr Jr Jr Jr+ Jr Sr Sr Jr Jr Sr Gr Sr Gr Sr Gr Gr

7 Resudent Hip Knee OA 25 Jr st st+ st+ Jr Jr Sr Jr Sr Sr Jr Jr Sr Gr Sr Gr Sr Gr Gr Gr Hip Knee OA 26 Jr+ st st Jr Jr Jr Jr+ Jr Sr Sr Jr Jr Sr Gr Sr Gr Sr Gr Gr Gr Scoring student + Jr Res + Sr Res + Graduate + Faculty Service Competency Milestone Score Adult MK Hip Knee OA 25 Adult PC Hip Knee OA 26 F&A MK Ankle Arthritis 9 F&A PC Ankle Arthritis 10 Hand MK Carpal Tunnel 13 Hand PC Carpal Tunnel 14 Onc MK Metastatic Lesion 29 Onc PC Metastatic Lesion 30 Ped MK Septic Hip 35 Ped PC Septic Hip 36 Ped MK Supracondylar Humerus Fracture 39 Ped PC Supracondylar Humerus Fracture 41 Shoulder MK Rotator Cuff 37 Shoulder PC Rotator Cuff 38 Spine MK Degen Spine 15 Spine PC Degen Spine 16 Sport MK ACL 7 Sport PC ACL 8 Sport MK Meniscal Tear 33 Sport PC Meniscal Tear 34 Trauma MK Adult Elbow Fracture 23 Trauma PC Adult Elbow Fracture 24 Trauma MK Ankle Fracture 11 Trauma PC Ankle Fracture 12 Trauma MK Diabetic Foot 17 Trauma PC Diabetic Foot 18 Trauma MK Diaphyseal Femur and Tibia Fracture 19 Trauma PC Diaphyseal Femur and Tibia Fracture 20 Trauma MK Distal Radius Fracture 21 Trauma PC Distal Radius Fracture 22 Trauma MK Hip Fracture 27 Trauma PC Hip Fracture 28 General Prof Compassion Integrity Respect 43 General Prof Accountability 44 General PBLI Self-Directed Learning 45 General PBLI Evidence Based Medicine 46 General SBM Systems Thinking 47 General SBM Interprofessional Patient Safety 48a General SBM EHR 48b General ICS Communication 49 General ICS Teamwork 50 Name: Date: 3/9/2015 Faculty focused iterative learning and facilitation one-on-one, usually GoToMeeting selective spreadsheet ACGME Milestone descriptions selective milestones specific to sub-specialty start with MK and PC for specialty progress to Prof, ISC, PBL, SBP Behavior Patient Care Medical Knowledge Hip Knee OA 25 Ankle Arthritis 9 Carpal Tunnel 13 Metastatic Lesion 29 Septic Hip 35 Supracondylar Humerus Fracture 39 Rotator Cuff 37 Degen Spine 15 ACL 7 Meniscal Tear 33 Adult Elbow Fracture 23 Ankle Fracture 11 Diabetic Foot 17 Diaphyseal Femur and Tibia Fracture 19 Distal Radius Fracture 21 Hip Fracture 27 Hip Knee OA 26 Ankle Arthritis 10 Carpal Tunnel 14 Metastatic Lesion 30 Septic Hip 36 Supracondylar Humerus Fracture 41 Rotator Cuff 38 Degen Spine 16 ACL 8 Meniscal Tear 34 Adult Elbow Fracture 24 Ankle Fracture 12 Diabetic Foot 18 Diaphyseal Femur and Tibia Fracture 20 Distal Radius Fracture 22 Hip Fracture 28 Compassion Integrity Respect 43 Accountability 44 Self-Directed Learning 45 Evidence Based Medicine 46 Systems Thinking 47 Interprofessional Patient Safety 48a EHR 48b Communication 49 Teamwork 50 Milestones: Faculty Assessment 1 Hustedt 1 Palsis 1 Patel 1 Richards2Bingham 2Goltzer 2Hosack 2Roberts 3Fraser 3Klempf 3Swanson3Wood 4Abildgaar4Jarbp 4Odgers 4Schmidt 4 Cummin5Harmsen5Patterson N N N N N N N N N Sr N N N Sr N Sr N N N N N N N N N N N St Jr st+ st+ Sr Jr+ Sr Sr Sr Gr Gr N N N N N N N N Sr N N N Gr N Sr Gr N Sr Sr N N N N Jr Jr N Jr Sr Sr Jr+ Jr+ Sr Sr Sr Sr Sr Gr Gr N N N N N N N N N N Jr+ N Gr Gr Gr Sr+ Gr Gr Gr N N N N N N N N N N Jr+ N Gr Gr Gr Sr+ Gr Gr Gr N N N N N N N N Sr Sr Sr Sr Sr Sr Sr Sr Sr Sr Gr Jr N N Jr Jr Jr Jr+ Jr Jr+ Jr+ Jr+ N N Sr+ N Gr Jr+ Gr Gr N N N N N N N N Jr N N Sr Sr Sr Sr Sr Sr Sr Gr N N N N N N N N Jr N N Sr Sr Sr Sr Sr Sr Sr Gr N N N N St+ St+ N N Jr Jr Jr St+ Sr Jr+ Jr+ Jr+ Sr+ Jr Jr+ N N N N N N N N N Sr N N N Jr N Jr N N N N N N N N N N N St+ Jr st+ St+ Sr Jr+ Sr Sr Sr Gr Gr N N N N N N N N Sr N N N Gr N Sr Sr N Gr Sr N N N N Jr Jr N Jr Sr Sr Jr+ Jr+ Sr Sr Sr Sr Sr Gr Gr N N N N N N N N N N Sr N Gr Gr Gr Sr+ Gr Gr Gr N N N N N N N N N N Sr N Gr Gr Gr Sr+ Gr Gr Gr N N N N N N N N Sr Sr Sr Sr Sr Sr Sr Sr Sr Sr Gr N N N N N N Jr N Jr+ Jr+ Jr+ N N Gr N Gr N Gr Gr N N N N N N N N Jr N N Jr Jr Jr Jr Jr Sr Sr Sr N N N N N N N N Jr N N Jr Jr Sr Jr Sr Sr Sr Sr N N N N St+ St+ N N Jr Jr Sr St+ Sr Jr+ Jr+ Jr+ Sr+ Jr Jr+ N N N N St+ St+ N N Jr Jr Sr St+ Gr Gr Sr+ Sr Gr Sr Sr N N N N N N Gr Gr Gr Gr Gr N N Gr N Gr Gr Gr Gr N N N N N N Gr Gr Gr Gr Gr N N Gr N Gr Gr Gr Gr N N N N Jr Jr N Jr Gr Sr Jr+ Jr+ Gr Gr Gr Gr Gr Gr Gr N N N N Jr Jr N Jr Sr Sr Jr+ Jr+ Gr Gr Gr Gr Gr Gr Gr N N N N Gr Gr N Gr Gr Gr Gr Gr Gr Gr Gr Gr Gr Gr Gr N N N N N N N N Sr N N N Sr N Sr Sr N Sr Sr N N N N N N N N Sr N N N Sr N Sr Sr N Sr Sr Residents self-evaluation one-on-all at Program Core Conference all milestones start with MK and PC progress to Prof, ISC, PBL, SBP stepwise, all residents same question--same time review key principles on each milestone Milestones Self Assessment Behavior Patient Care Medical Knowledge Milestones: Resident Self-Assessment Jr st st+ st+ Jr Jr Sr. Sr Sr Jr Jr Sr Gr Sr Gr Sr Gr Gr Gr Jr st st st+ Jr Jr Sr. Jr Jr Jr Jr Gr Sr+ Gr Jr Sr Sr+ Gr Gr Jr+ st+ st+ st+ st Jr Jr+. Gr Jr Jr Jr Gr Gr Gr Gr Jr Gr Gr Gr Jr st st st+ Jr st Sr. Sr Jr+ Sr Jr Sr Gr Sr Gr Sr Gr Gr Gr Jr st st st+ Jr st Jr+. Jr Jr Sr Jr Sr+ Gr+ Sr+ Gr Gr Gr Gr Gr Jr st st st+ st st Jr. Sr Jr+ Jr Jr Sr Gr Sr Gr Gr Gr Gr Gr Jr st st+ Jr Jr st+ Jr. Gr Jr+ Jr Jr Sr Gr Sr Sr Sr Gr Gr Gr Jr+ st st st Jr Jr Sr. Sr Jr Sr Jr Jr+ Gr Jr+ Gr+ Jr Gr Gr Gr Jr st st st st Jr Jr+. Sr Jr+ Jr Jr Sr Gr Sr Gr Sr Gr Gr Gr Jr st st Jr st Jr Jr+. Sr Jr+ Jr Jr Sr Gr Sr Gr Gr Gr Gr+ Gr Jr st st st Jr Jr Jr. Jr Jr Jr Jr Sr Sr+ Sr Jr+ Sr Gr Gr Gr Jr+ st+ st Jr Jr Jr Sr. Sr Jr+ Sr Jr+ Sr Gr Sr Jr+ Gr Gr Gr Gr Jr+ st st+ st Jr Jr Jr. Jr Jr Sr Jr Sr Sr+ Sr Sr Sr Gr Gr Gr Jr+ st st Jr Jr Jr Sr. Sr Jr+ Sr Jr Sr Gr Sr Sr Sr Gr Gr Gr Jr st st st Jr Jr Sr. Sr Jr+ Jr Jr Sr Gr Sr Sr Sr Gr Gr Gr Jr+ st st st Jr+ Jr Sr. Gr Jr+ Sr Jr+ Sr Gr Sr Gr Gr Gr Gr Gr Jr+ st st Jr Jr Jr Jr+. Sr Sr Jr Jr Sr Gr Sr Gr Sr Gr Gr Gr Jr+ st st Jr Jr Jr Jr+. st st+ Jr Jr Gr Sr+ Gr Jr Sr Gr Sr+ Gr Jr+ st+ st+ st+ st st+ Jr+. Gr Jr Jr st Gr Gr Gr Gr Jr Gr+ Gr+ Gr Jr st st st+ Jr st Jr+. Sr Jr+ Sr Jr Sr Sr+ Sr Sr Sr Gr Gr Gr Jr st st st+ st st Jr+. Jr Jr+ Sr st Sr+ Gr Sr+ Gr Gr Gr Gr Gr Jr st st st+ st st st+. Sr Jr+ Jr st Sr Gr Sr Gr Gr Gr+ Gr Gr Jr st st Jr Jr st st+. Sr Jr+ Jr Jr Sr Sr+ Sr Jr Sr Gr Sr+ Gr Jr+ st st st st st+ Jr. Jr st+ Sr st Jr+ Gr Jr+ Gr Jr Sr+ Gr Gr Jr st st Jr st st Jr. Sr Jr Jr Jr Sr Sr+ Sr Gr Sr Gr Gr Gr Jr st st Jr st st Jr. Sr Jr Jr Jr Sr Gr Sr Gr Gr Gr+ Gr Gr Jr st st st st Jr Jr. Jr Jr Jr Jr Sr Sr Sr Jr+ Sr Gr Gr Gr Jr+ st st st Jr Jr Jr+. Jr Jr Jr Jr+ Sr Gr Sr Jr+ Gr Gr Gr Gr Jr+ st st st Jr Jr st+. Jr Jr Sr Jr Sr Sr+ Sr Jr Sr Sr+ Sr+ Gr Jr+ st st st Jr Jr Jr+. Sr Jr+ Sr Jr Sr Sr+ Sr Sr Sr Gr+ Gr Gr Jr st st st Jr Jr Jr+. Sr Jr Jr Jr Sr Gr Sr Sr Sr Gr Gr Gr Jr+ st st st Jr Jr Jr+. Gr Jr+ Sr Jr+ Sr Sr+ Sr Gr Gr Gr+ Gr+ Gr Sr Jr Jr Jr Fac Jr Sr+. Gr Sr Gr Jr Gr Fac Gr Gr Sr Gr Gr+ Gr Sr Jr Jr Jr Fac Jr Sr+. Gr Sr Jr Jr Gr Gr Gr Gr Gr Gr Gr Gr Sr st+ Jr Jr Gr Jr Gr. Gr Jr+ Jr st+ Gr Gr Gr Gr Sr Gr Gr Gr Sr st+ st Jr Sr Jr Sr. Gr Jr+ Jr Jr Gr Gr Gr Gr Sr Gr Gr Gr Jr+ st+ st st Sr Jr Jr. Fac Sr Sr st+ Gr Gr Gr Gr Sr Gr Gr Gr Sr st+ Jr st Fac Jr Jr. Gr Sr Sr Jr Gr Gr Gr Sr Sr Gr Gr Gr Sr st+ Jr st Gr Jr Sr+. Fac Sr Sr Jr Gr Sr Gr Gr Sr Gr Gr Gr Sr Jr Jr st Gr Jr Sr+. Gr Sr Jr st+ Gr Fac Gr Sr Sr Gr Gr Gr Sr Jr Jr st Fac Sr Gr. Gr Sr Sr Jr Gr Gr+ Gr Jr+ Sr Gr Gr Gr Keep Faculty on track Iterative collaborative learning resident and faculty common, defined goals faculty member details and nuances for specialty specific milestones objective & longitudinal consistent residents milestones goals for each rotation 7

8 Milestones Learning anticipate: functional behavior in 8 rotations 4 semi-annual evaluations Discussion 8

Accreditation Council for Graduate Medical Education

Orthopaedic Surgery Case Logs National Data Report Accreditation Council for Graduate Medical Education Prepared by: Department of Applications and Data Analysis I. National ident Statistics Main Table