Are They “Competent For Unsupervised Practice”?

Milestones: Residency program directors will be interested in this description of end-of-year milestones data from 2,030 categorical pediatric residents in  forty-seven representative 3-year categorical programs.  Milestones are generally rated on a 1-5 scale for 21 different subcompetencies.  In pediatrics, milestone ratings are anchored by behavior descriptions.  (In some other specialties, ratings are explicitly benchmarked with level 4 described as “ready for unsupervised practice.”)  As anticipated, median subcompetency milestone rankings increased with year of training, from 2.5-3.0 for first-year residents to 4.0 (for all subcompetencies except quality improvement) for third-year residents.  The gap in milestone ranking between the lowest 10% and highest 10% of residents closed substantially over year of training, as well.  Overall, 21% of graduating residents achieved a score of at least 4 in all subcompetencies, and 79% achieved a score of at least 3 in all subcompetencies. — Laura Willett, MD

Li ST, Tancredi DJ, Schwartz A, Guillot AP, Burke AE, Trimm RF, Guralnick S, Mahan JD, Gifford KA; Association of Pediatric Program Directors (APPD) Longitudinal Educational Assessment Research Network (LEARN) Validity of Resident Self-Assessment Group. Competent for Unsupervised Practice: Use of Pediatric Residency Training Milestones to Assess Readiness. Acad Med. 2016 July

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