Abstract
To optimize post-graduate competency-based assessment for medical trainees, the Accreditation Council for Graduate Medical Education initiated a sub-specialty-specific revision of the existing Milestones 1.0 assessment framework in 2016. This effort was intended to increase both the effectiveness and accessibility of the assessment tools by incorporating specialty-specific performance expectations for medical knowledge and patient care competencies; decreasing item length and complexity; minimizing inconsistencies across specialties through the development of common “harmonized” milestones; and providing supplemental materials, including examples of expected behaviors at each developmental level, suggested assessment strategies, and relevant resources. This manuscript describes the efforts of the Neonatal-Perinatal Medicine Milestones 2.0 Working Group, outlines the overall intent of Milestones 2.0, compares the novel Milestones to the original version, and details the materials contained in the novel supplemental guide. This new tool should enhance NPM fellow assessment and professional development while maintaining consistent performance expectations across specialties.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 12 print issues and online access
$259.00 per year
only $21.58 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
Similar content being viewed by others
Data availability
No research data was collected during this portion of the initiative. The novel NPM Milestones 2.0 will be available through the ACGME in July 2023.
References
Hicks PJ, Schumacher DJ, Benson BJ, Burke AE, Englander R, Guralnick S, et al. The pediatrics milestones: conceptual framework, guiding principles, and approach to development. J Grad Med Educ. 2010;2:410–8.
Nasca TJ, Philibert I, Brigham T, Flynn TC. The next ACGME accreditation system: rationale and benefits. NEJM 2012;366:1051–6.
Edgar L, Roberts S, Holmboe E. Milestones 2.0: a step forward. J Grad Med Educ. 2018;10:367–9.
Cate O, Billett S. Competency-based medical education: origins, perspectives, and potentialities. Med Educ. 2014;48:325–32.
Batalden P, Leach D, Swing S, Dreyfus H, Dreyfus S. Health Aff (Millwood). 2002; 21:103–11.
Edgar L, McLean S, Hogan S, Hamstra S, Holmboe ES. The Milestones Handbook. Accreditation Council for Graduate Medical Education; 2020. Available from: https://www.acgme.org/globalassets/milestonesguidebook.pdf. Accessed 12/7/2022.
Carbajal MM, Dadiz R, Sawyer TL, Kane S, Frost M, ONTPD Fellowship Directors Writing Group, et al. Part 5: essentials of neonatal-perinatal medicine fellowship: evaluation of competence and proficiency using milestones. J Perinatol. 2022;42:809–14.
McLean S, Edgar L, Harsy B. The milestones 2.0 development process. J Grad Med Educ. 2021;13:4–7.
Lewis KO, Hathaway SB, Bratcher D, Blowey D, Knapp JF. Current milestones assessment practices, needs, and challenges of program directors: a collective case study in a pediatric hospital setting. Cureus 2021;13:e14585.
Sawyer T, Gray M, Chabra S, Johnston LC, Carbajal MM, Gillam-Krakauer M, et al. Milestone level changes from residency to fellowship: a multi-center cohort study. J Grad Med Educ. 2021;13:377–84.
Edgar L, Roberts S, Yaghmour NA, Leep Hunderfund A, Hamstra SJ, Conforti L, et al. Competency crosswalk: a multispecialty review of the accreditation council for graduate medical education milestones across four competency domains. Acad Med. 2018;93:1035–41.
Carracio C, Benson B, Burke A, Englander R, Guralnick S, Hicks S, et al. The pediatric subspecialties milestones project. Accreditation council for graduate medical education; 2015. Available at: https://www.acgme.org/globalassets/pdfs/milestones/pediatricssubspecialtymilestones.pdf. Accessed 12/5/2022.
Lim J, Westerman ME, Stewart NH, Correa R, Eno C. Trainee perspectives on the writing and implementation of milestones 2.0. J Grad Med Educ. 2021;13:8–10.
Acknowledgements
The NPM Milestones 2.0 Workgroup would like to acknowledge the leadership and members of the Organization of Neonatology Training Program Directors (ONTPD) and Training and Early Career Neonatologists (TECaN) for feedback on this effort and the ACGME staff who made this work possible.
Author information
Authors and Affiliations
Contributions
KB and MG conceptualized this work, and KB drafted the initial manuscript. All authors reviewed and revised the manuscript for important intellectual content. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.
Corresponding author
Ethics declarations
Competing interests
Laura Edgar is an employee of the Accreditation Council for Graduate Medical Education (ACGME). The other authors declare no competing interests.
Additional information
Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
Berlin, K.E.K., Gray, M.M., Myers, P.J. et al. A new era of assessment for neonatal-perinatal medicine trainees: milestones 2.0. J Perinatol 43, 1506–1512 (2023). https://doi.org/10.1038/s41372-023-01683-8
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1038/s41372-023-01683-8
