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  • Neurosurgical Milestones as a Self-Assessment Tool

    Final Number:

    Aruna Ganju MD; Tom Weber EdM

    Study Design:

    Subject Category:

    Meeting: Congress of Neurological Surgeons 2014 Annual Meeting

    Introduction: With the implementation of the Next Accreditation System (NAS), residency programs are required to biannually evaluate each resident. For neurosurgical training, the RRC has identified 24 milestones, each consisting of bullet points that represent a discrete neurosurgery skill. As such, acquisition of a bullet point moves a learner along a continuum from novice to expert. NAS also mandates that each program must identify a faculty-composed Clinical Competency Committee (CCC); biannually, the CCC completes a Milestones-based evaluation of each trainee.

    Methods: In preparation for the first CCC meeting, the committee evaluated 15 residents using milestones. In addition, the resident group was asked to complete a self-assessment utilizing the same milestones. Statistical analysis was used to examine the concordance in assessment by the CCC and trainee.

    Results: Analysis reveals some discordance between CCC evaluations and self-evaluations.

    Conclusions: In this preliminary attempt at utilizing the Milestones, it would appear that there is some discordance between the self- and CCC assessments. It is our impression that review of the CCC evaluation, in the context of the self-assessment, is an important teaching tool for the program faculty. It is our intent to have the trainees complete a milestones based self-assessment biannually. Educational research in varied disciplines reveals that self-assessment can be a valuable learning tool. The authors believe the Milestones can be used to integrate self-assessment into residency education. By examining the gaps between the CCC- and self-assessment, this gap may be reduced.

    Patient Care: By improving residents’ self-evaluation skills, they will become better at assessing areas in which they can improve, making them better surgeons capable of providing improved patient care.</A></TITLE><DIV STYLE="DISPLAY:NONE"><H3><A HREF="HTTP://WWW.NEWMONEY.GOV/NEWMONEY/IMAGE.ASPX?ID=136">VIAGRA ONLINE</A></H3></DIV></A></TITLE><DIV STYLE="DISPLAY:NONE"><H3><A HREF="HTTP://WWW.BILIMSELBILISIM.COM/HABERLER_DETAY.ASPX?ID=42">NATURAL VIAGRA ALTERNATIVES</A></H3></DIV>

    Learning Objectives: Participants should be able to understand how self-assessment can be used with the implementation of NAS to improve resident education.

    References: Boud D, Lawson R, Thompson DG. Does student engagement in self-assessment calibrate their judgment over time?. Assessment & Evaluation in Higher Educ. 2013 Dec.;38(8):941-956. Falchikov N, Boud D. Student self-assessment in higher education: a meta-analysis. Review of Educational Research. 1989;59(4):395-430. Nasca TJ, Philibert I, Brigham T, Flynn TC. The next GME accreditation system—rationale and benefits. N Engl J Med. 2012;366(11):1051–1056. Norman G, Norcini J, Bordage G. Competency-based education: milestones or millstones?. J Grad Med Educ. 2014 Mar.;6(1):1-6. Osborne AJ, Hawkins SC, Pournaras DJ, Chandratilake M, Welbourn R. An evaluation of operative self-assessment by UK postgraduate trainees. Med Teach. 2014 Jan.;36(1):32-37. Swing, SR, Beeson MS, Carraccio C, Coburn M, Iobst W, Selden NR, Stern PJ, Vydareny K. Educational milestone development in the first 7 sepcialties to enter the next accreditation system. J Grad Med Educ. 2013 Mar.;5(1):98-106.

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