"PLEASE Complete Your Evaluations!" Strategies to Engage Faculty in Competency-Based Assessments.

Competency-based assessments (CBAs) have gained traction in graduate medical education and inform important learner outcomes through the continuum of medical training. Active participation in new CBAs presents challenges to faculty working in a busy clinical environment. As such, the implementation of new CBAs can be approached with intention to foster acceptance and engagement with new evaluations.

Reported Pediatrics Milestones (Mostly) Measure Program, Not Learner Performance.

Purpose: Semiannually, U.S. pediatrics residency programs report resident milestone levels to the Accreditation Council for Graduate Medical Education (ACGME).

The Emergence and Spread of Practice-Based Medical Education Research Networks.

Educational research networks leverage shared goals and common infrastructure to overcome traditional barriers to medical education research, including small sample sizes, lack of generalizability, need for expertise in statistical analysis, and limitations on data sharing. The diversity of extant network models today is exciting and provides a set of common options and challenges that newly emerging networks can expect. These include decisions about network focus, organization of data, sampling strategies, funding, and governance.

ARAF recurrent mutation causes central conducting lymphatic anomaly treatable with a MEK inhibitor.

The treatment of lymphatic anomaly, a rare devastating disease spectrum of mostly unknown etiologies, depends on the patient manifestations. Identifying the causal genes will allow for developing affordable therapies in keeping with precision medicine implementation. Here we identified a recurrent gain-of-function ARAF mutation (c.

Does Incorporating a Measure of Clinical Workload Improve Workplace-Based Assessment Scores? Insights for Measurement Precision and Longitudinal Score Growth From Ten Pediatrics Residency Programs.

Purpose: This study investigates the impact of incorporating observer-reported workload into workplace-based assessment (WBA) scores on (1) psychometric characteristics of WBA scores and (2) measuring changes in performance over time using workload-unadjusted versus workload-adjusted scores.

Method: Structured clinical observations and multisource feedback instruments were used to collect WBA data from first-year pediatrics residents at 10 residency programs between July 2016 and June 2017. Observers completed items in 8 subcompetencies associated with Pediatrics Milestones.

Pathogenic variant in EPHB4 results in central conducting lymphatic anomaly.

Central conducting lymphatic anomaly (CCLA) is one of the complex lymphatic anomalies characterized by dilated lymphatic channels, lymphatic channel dysmotility and distal obstruction affecting lymphatic drainage. We performed whole exome sequencing (WES) of DNA from a four-generation pedigree and examined the consequences of the variant by transfection of mammalian cells and morpholino and rescue studies in zebrafish. WES revealed a heterozygous mutation in EPHB4 (RefSeq NM_004444.

A novel workplace-based assessment for competency-based decisions and learner feedback.

Background: Increased recognition of the importance of competency-based education and assessment has led to the need for practical and reliable methods to assess relevant skills in the workplace.

Methods: A novel milestone-based workplace assessment system was implemented in 15 pediatrics residency programs. The system provided: (1) web-based multisource feedback (MSF) and structured clinical observation (SCO) instruments that could be completed on any computer or mobile device; and (2) monthly feedback reports that included competency-level scores and recommendations for improvement.

Validity Evidence From Ratings of Pediatric Interns and Subinterns on a Subset of Pediatric Milestones.

Purpose: To investigate evidence for validity of faculty members' pediatric milestone (PM) ratings of interns (first-year residents) and subinterns (fourth-year medical students) on nine subcompetencies related to readiness to serve as a pediatric intern in the inpatient setting.

Method: The Association of Pediatric Program Directors Longitudinal Educational Assessment Research Network (APPD LEARN) and the National Board of Medical Examiners collaborated to investigate the utility of assessments of the PMs for trainees' performance. Data from 32 subinterns and 179 interns at 17 programs were collected from July 2012 through April 2013.

The Pediatrics Milestones Assessment Pilot: Development of Workplace-Based Assessment Content, Instruments, and Processes.

Purpose: To report on the development of content and user feedback regarding the assessment process and utility of the workplace-based assessment instruments of the Pediatrics Milestones Assessment Pilot (PMAP).

Method: One multisource feedback instrument and two structured clinical observation instruments were developed and refined by experts in pediatrics and assessment to provide evidence for nine competencies based on the Pediatrics Milestones (PMs) and chosen to inform residency program faculty decisions about learners' readiness to serve as pediatric interns in the inpatient setting. During the 2012-2013 PMAP study, 18 U.

Medical education practice-based research networks: Facilitating collaborative research.

Background: Research networks formalize and institutionalize multi-site collaborations by establishing an infrastructure that enables network members to participate in research, propose new studies, and exploit study data to move the field forward. Although practice-based clinical research networks are now widespread, medical education research networks are rapidly emerging.

Aims: In this article, we offer a definition of the medical education practice-based research network, a brief description of networks in existence in July 2014 and their features, and a more detailed case study of the emergence and early growth of one such network, the Association of Pediatric Program Directors Longitudinal Educational Assessment Research Network (APPD LEARN).

An online evidence based medicine exercise prompts reflection in third year medical students.

Background: Reflective practice is a desirable trait in physicians, yet there is little information about how it is taught to or learned by medical students. The purpose of this study was to determine whether an online Evidence Based Medicine (EBM) exercise with a face-to-face debriefing session would prompt third year medical students to reflect on their current skills and lead them to further reflection on clinical decision making in the future.

Methods: All third year medical students at the University Of Maryland School Of Medicine who completed their pediatrics clerkship between 7/1/09 and 2/11/11 were required to complete the EBM exercise.

Front-line ordering clinicians: matching workforce to workload.

Background: Matching workforce to workload is particularly important in healthcare delivery, where an excess of workload for the available workforce may negatively impact processes and outcomes of patient care and resident learning. Hospitals currently lack a means to measure and match dynamic workload and workforce factors.

Objectives: This article describes our work to develop and obtain consensus for use of an objective tool to dynamically match the front-line ordering clinician (FLOC) workforce to clinical workload in a variety of inpatient settings.

The pediatrics milestones: initial evidence for their use as learning road maps for residents.

Objective: As the next step in competency-based medical education, the Pediatrics Milestone Project seeks to provide a learner-centered approach to training and assessment. To help accomplish this goal, this study sought to determine how pediatric residents understand, interpret, and respond to the Pediatrics Milestones.

Methods: Cognitive interviews with 48 pediatric residents from all training levels at 2 training programs were conducted.

Perspective: beyond counting hours: the importance of supervision, professionalism, transitions of care, and workload in residency training.

The medical education community's conversations about residents' duty hours have long focused solely on the number of those hours. In July 2011, the Accreditation Council for Graduate Medical Education (ACGME) enacted its most recent iteration of standards regarding duty hours. Those standards, as well as a 2008 Institute of Medicine report, look beyond the quantity of duty hours to address their quality as well.

Pediatrics milestone project: next steps toward meaningful outcomes assessment.

In the September 2010 issue of JGME, the Pediatric Milestones Working Group published "The Pediatrics Milestones: Conceptual Framework, Guiding Principles, and Approach to Development", a document that describes the construction of the first iteration of the Pediatric Milestones. These Milestones were developed by the Working Group as a group of practical behavioral expectations for each of the 52 sub-competencies. In constructing these Milestones, the authors were cognizant of the need to ground the Milestones themselves in evidence, theories or other conceptual frameworks that would provide the basis for the ontogeny of development for each sub-competency.

The pediatrics milestones: conceptual framework, guiding principles, and approach to development.

Background: The Accreditation Council for Graduate Medical Education (ACGME) and the American Board of Pediatrics (ABP) have partnered to initiate the Pediatrics Milestone Project to further refine the 6 ACGME competencies and to set performance standards as part of the continued commitment to document outcomes of training and program effectiveness.

Intervention: Members of the Pediatrics Milestone Project Working Group searched the medical literature and beyond to create a synopsis of models and evidence for a developmental ontogeny of the elements for 52 subcompetencies. For each subcompetency, we created a series of Milestones, grounded in the literature.