Purpose: Semiannually, U.S. pediatrics residency programs report resident milestone levels to the Accreditation Council for Graduate Medical Education (ACGME). The Pediatrics Milestones Assessment Collaborative (PMAC, consisting of the National Board of Medical Examiners, American Board of Pediatrics, and Association of Pediatric Program Directors) developed workplace-based assessments of 2 inferences: readiness to serve as an intern with a supervisor present (D1) and readiness to care for patients with a supervisor nearby in the pediatric inpatient setting (D2). The authors compared learner and program variance in PMAC scores with ACGME milestones.
Method: The authors examined sources of variance in PMAC scores and milestones between November 2015 and May 2017 of 181 interns at 8 U.S. pediatrics residency programs using random effects models with program, competency, learner, and program × competency components.
Results: Program-related milestone variance was substantial (54% D1, 68% D2), both in comparison to learner milestone variance (22% D1, 14% D2) and program variance in the PMAC scores (12% D1, 10% D2). In contrast, learner variance represented 44% (D1) or 26% (D2) of variance in PMAC scores. Within programs, PMAC scores were positively correlated with milestones for all but one competency.
Conclusions: PMAC assessments provided scores with little program-specific variance and were more sensitive to differences in learners within programs compared with milestones. Milestones reflected greater differences by program than by learner. This may represent program-based differences in intern performance or in use of milestones as a reporting scale. Comparing individual learner milestones without adjusting for programs is problematic.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1097/ACM.0000000000003644 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Predictive Ability of the Pedal Medial Arterial Calcification Score for Major Adverse Limb Events Among Patients with Chronic Limb-Threatening Ischemia.
Ann Vasc Surg
January 2025
Southeast Wales Vascular Network, University Hospital of Wales, Cardiff, UK.
Background: Pedal medial arterial calcification (pMAC) is a potential predictor of major adverse limb events (MALEs) among patients with critical limb-threatening ischemia (CLTI). This study aims to validate the prognostic value of the pMAC score in predicting major lower-limb amputation (MLLA) and need for redo revascularisation.
Methods: A single-center study involving 196 patients diagnosed with CLTI, reviewed between 2012 and 2022.
Pancreatic mucinous adenocarcinoma has different clinical characteristics and better prognosis compared to non-specific PDAC: A retrospective observational study.
Heliyon
May 2024
Clinical Nursing Teaching and Research Section, Second Xiangya Hospital, Central South University, Hunan, China.
Article Synopsis
- Pancreatic mucinous adenocarcinoma (PMAC) is a rare and serious type of cancer, and researchers want to understand it better compared to the more common pancreatic ductal adenocarcinoma (PDAC).
- The study looked at data from a large database to find out how different factors, like treatment and the patient's background, affect survival rates for both types of cancer.
- Results showed that some people, like those who are married and get good treatment, tend to do better with PMAC, while others with certain high-risk conditions might not do as well.
Pedal medial arterial calcification influences the outcomes of isolated infra-malleolar interventions for chronic limb-threatening ischemia.
J Vasc Surg
September 2024
Center for Quality, Effectiveness, and Outcomes in Cardiovascular Diseases, Houston, TX; Department of Vascular and Endovascular Surgery, Ascension Health, Waco, TX. Electronic address:
Objective: Inframalleolar disease is present in most diabetic patients presenting with tissue loss. Inframalleolar (pedal) artery disease and pedal medial arterial calcification (pMAC) are associated with major amputation in patients with chronic limb-threatening ischemia (CLTI). This study aimed to examine the impact of pMAC on the outcomes after isolated inframalleolar (pedal artery) interventions.
View Article and Find Full Text PDFComparative effectiveness of chemotherapy in different histological types of pancreatic cancer: a PSM-based study using the SEER database.
J Chemother
April 2024
Department of Gastroenterology, The Second School of Clinical Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China.
This study aimed to compare the effectiveness of chemotherapy in different histological types of pancreatic cancer using data collected from the Surveillance, Epidemiology, and End Results (SEER) database. Patients who were diagnosed with pancreatic cancer between 2004 and 2015 were selected from the SEER database. Propensity score matching (PSM) was employed to minimize the selection bias.
View Article and Find Full Text PDFRelevance of BEST-CLI trial endpoints in a tertiary care limb preservation program.
J Vasc Surg
June 2024
University of California, San Francisco Department of Surgery, Division of Vascular and Endovascular Surgery, San Francisco, CA. Electronic address:
Objective: Major adverse limb event-free survival (MALE-FS) differed significantly by initial revascularization approach in the BEST-CLI randomized trial. The BEST-CLI trial represented a highly selected subgroup of patients seen in clinical practice; thus, we examined the endpoint of MALE-FS in an all-comers tertiary care practice setting.
Methods: This is a single-center retrospective study of consecutive, unique patients who underwent technically successful infrainguinal revascularization for chronic limb-threatening ischemia (2011-2021).
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!