Developing Competencies and Milestones: Putting the Pieces Together for Student Success.

Competency-based medical education has become a means in physician assistant (PA) education to ensure learner readiness for practice; align educational expectations; and assess knowledge, skills, and attitudes. Competency-based education may also serve to meet accreditation requirements. Creating program-defined competencies and associated milestones can help a PA program align with their mission and vision, developmentally guide learners through the curriculum, and ensure program assessments measure the tasks required of practice-ready graduates. This review provides an overview of a single program's process for developing program-defined competencies and associated milestones. Beginning with a literature search, the program was able to develop a working list of competencies that was then further refined into competencies with building block milestones that support the development of competency in various domains. Involving faculty in defining a program's competencies is an Accreditation Review Commission on Education for the Physician Assistant requirement that can be done from the ground up or by using previously published competencies that are refined and tailored for the program. The process of creating the competencies provides significant insight into a program's curriculum, goals and expectations for students, and assessment methods.