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{
    "pk": 18703,
    "title": "Emergency Medicine Milestones Final Ratings Are Often Subpar",
    "subtitle": null,
    "abstract": "<p><strong>Background: </strong>The emergency medicine (EM) milestones are objective behaviors that are categorized into thematic domains called “subcompetencies” (eg, emergency stabilization). The scale for rating milestones is predicated on the assumption that a rating (level) of 1.0 corresponds to an incoming EM-1 resident and a rating of 4.0 is the “target rating” (albeit not an expectation) for a graduating resident. Our aim in this study was to determine the frequency with which graduating residents received the target milestone ratings.</p>\n<p><strong>Methods: </strong>This retrospective, cross-sectional study was a secondary analysis of a dataset used in a prior study but was not reported previously. We analyzed milestone subcompetency ratings from April 25–June 24, 2022 for categorical EM residents in their final year of training. Ratings were dichotomized as meeting the expected level at the time of program completion (ratings of ≥3.5) and not meeting the expected level at the time of program completion (ratings of ≤3.0). We calculated the number of residents who did not achieve target ratings for each of the subcompetencies.</p>\n<p><strong>Results:</strong> In Spring 2022, of the 2,637 residents in the spring of their last year of training, 1,613 (61.2%)<br>achieved a rating of ≥3.5 on every subcompetency and 1,024 (38.8%) failed to achieve that rating on at least one subcompetency. There were 250 residents (9.5%) who failed to achieve half of their expected<br>subcompetency ratings and 105 (4.0%) who failed to achieve the expected rating (ie, rating was ≤3.0) on every subcompetency.</p>\n<p><strong>Conclusion:</strong> When using an EM milestone rating threshold of 3.5, only 61.2% of physicians achieved the target ratings for program graduation; 4.0% of physicians failed to achieve target ratings for any milestone subcompetency; and 9.5% of physicians failed to achieve the target ratings for graduating residents in half of the subcompetencies.</p>",
    "language": null,
    "license": {
        "name": "Creative Commons Attribution 4.0",
        "short_name": "CC BY 4.0",
        "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.",
        "url": "https://creativecommons.org/licenses/by/4.0"
    },
    "keywords": [
        {
            "word": "Resident Training"
        },
        {
            "word": "milestones"
        },
        {
            "word": "competencies"
        }
    ],
    "section": "Education",
    "is_remote": true,
    "remote_url": "https://escholarship.org/uc/item/0j68g4n5",
    "frozenauthors": [
        {
            "first_name": "Diane",
            "middle_name": "L.",
            "last_name": "Gorgas",
            "name_suffix": "",
            "institution": "Ohio State University Wexner Medical Center, Department of Emergency Medicine, Columbus, Ohio",
            "department": ""
        },
        {
            "first_name": "Kevin",
            "middle_name": "B.",
            "last_name": "Joldersma",
            "name_suffix": "",
            "institution": "American Board of Emergency Medicine, East Lansing, Michigan",
            "department": "None"
        },
        {
            "first_name": "Felix",
            "middle_name": "K.",
            "last_name": "Ankel",
            "name_suffix": "",
            "institution": "Regions Hospital, Department of Emergency Medicine, St. Paul, Minnesota",
            "department": "None"
        },
        {
            "first_name": "Wallace",
            "middle_name": "A.",
            "last_name": "Carter",
            "name_suffix": "",
            "institution": "Weill Cornell Medicine, Department of Emergency Medicine, New York, New York",
            "department": "None"
        },
        {
            "first_name": "Melissa",
            "middle_name": "A.",
            "last_name": "Barton",
            "name_suffix": "",
            "institution": "American Board of Emergency Medicine, East Lansing, Michigan",
            "department": "None"
        },
        {
            "first_name": "Earl",
            "middle_name": "J.",
            "last_name": "Reisdorff",
            "name_suffix": "",
            "institution": "American Board of Emergency Medicine, East Lansing, Michigan",
            "department": ""
        }
    ],
    "date_submitted": "2024-01-16T21:03:02Z",
    "date_accepted": "2024-06-14T18:59:00.168000Z",
    "date_published": "2024-08-16T13:00:00Z",
    "render_galley": {
        "label": "Final Article",
        "type": "pdf",
        "path": "https://journalpub.escholarship.org/westjem/article/18703/galley/25958/download/"
    },
    "galleys": [
        {
            "label": "Layout",
            "type": "pdf",
            "path": "https://journalpub.escholarship.org/westjem/article/18703/galley/24573/download/"
        },
        {
            "label": "Final Article",
            "type": "pdf",
            "path": "https://journalpub.escholarship.org/westjem/article/18703/galley/25958/download/"
        }
    ]
}