Thursday, July 2, 2015

The Pediatrics Milestones: Initial Evidence for Their Use as Learning Roadmaps for Residents

Daniel Schumacher, MD, MEd
Cincinnati Children's Hospital Medical Center

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 seeks 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 two Midwest training programs were conducted. Each participant reviewed one Pediatrics Milestone document. Eight total Pediatrics Milestones, chosen for their range of complexity, length, competency domain, and primary author, were included in this study. Thus, six residents reviewed each Pediatrics Milestone studied. Interviews were transcribed and coded using inductive methods, and codes were grouped into themes that emerged.

Results: Four major themes emerged though coding and analysis of the Pediatrics Milestones studied: 1) residents demonstrate sufficient, often deep, understanding of them; 2) residents use their own experiences to understand them; 3) residents are generally comfortable being placed before the end of a series of developmental milestones; and 4) they serve as roadmaps for learning. Two minor themes focusing on interest and practicality were also identified.

Conclusions: This study provides initial evidence for the Pediatrics Milestones as learner-centered documents that can be used for orientation, education, formative feedback, and, ultimately, for assessment.