Milestone-Based Assessments Are Superior to Likert-Type Assessments in Illustrating Trainee Progression

• DOI: 10.4300/jgme-d-14-00389.1
• Publication Date: 2014-12-19T21:39:17Z
• Authors: Kathleen W. Bartlett; Shari A. Whicker; Jack Bookman; Aditee P. Narayan; Betty B. Staples; Holly Hering; Kathleen A. McGann
• Keywords: Milestone; Graduate medical education

The Pediatrics Milestone Project uses behavioral anchors, narrative descriptions of observable behaviors, to describe learner progression through the Accreditation Council for Graduate Medical Education competencies. Starting June 2014, pediatrics programs were required submit milestone reports their trainees semiannually. Likert-type scale assessment tools not designed inform reporting, creating a challenge Clinical Competency Committees.To determine if milestone-based assessments better stratify by training level compared assessments.We results 3 subcompetencies after changing from 5-point Likert anchors in July 2013. Program leadership evaluated new system (1) comparing PGY-1 mean scores on versus assessments; and (2) across PGY levels.Mean residents significantly higher prior year's than all (P < .01). Stratification was observed with (eg, interpersonal communication skills 1 [ICS1] score PGY-1, 3.99 PGY-3, 3.98; P = .98). In contrast, demonstrated stratification ICS1 3.06 3.83 PGY-2, PGY-3; .01 PGY-3). Significantly different means trainee noted 21 PGY-3).Initial indicate performance assessments. Average PGY-level may ultimately provide guidance determining whether are progressing at expected pace.