Abstract
BackgroundThe changing healthcare landscape requires physicians to develop new knowledge and skills such as high-value care, systems improvement, population health, and team-based care, which together may be referred to as the Science of Health Care Delivery (SHCD). To engender public trust and confidence, educators must be able to meaningfully assess physicians’ abilities in SHCD. We aimed to develop a novel set of SHCD milestones based on published Accreditation Council for Graduate Medical Education (ACGME) milestones that can be used by medical schools to assess medical students’ competence in SHCD.MethodsWe reviewed all ACGME milestones for 25 specialties available in September 2013. We used an iterative, qualitative process to group the ACGME milestones into SHCD content domains, from which SHCD milestones were derived. The SHCD milestones were categorized within the current ACGME core competencies and were also mapped to Association of American Medical Colleges’ Entrustable Professional Activities (AAMC EPAs).ResultsFifteen SHCD sub-competencies and corresponding milestones are provided, grouped within ACGME core competencies and mapped to multiple AAMC EPAs.ConclusionsThis novel set of milestones, grounded within the existing ACGME competencies, defines fundamental expectations within SHCD that can be used and adapted by medical schools in the assessment of medical students in this emerging curricular area. These milestones provide a blueprint for SHCD content and assessment as ongoing revisions to milestones and curricula occur.
Highlights
The changing healthcare landscape requires physicians to develop new knowledge and skills such as high-value care, systems improvement, population health, and team-based care, which together may be referred to as the Science of Health Care Delivery (SHCD)
SHCD is an emerging curricular area within medical education, and a common set of SHCD milestones may help facilitate the successful preparation of medical students for residency and twenty-first century clinical practice
As a medical student would not be expected to demonstrate full competency in all domains by graduation, assessment of SHCD milestones will need to continue during graduate medical education (GME) and beyond
Summary
The changing healthcare landscape requires physicians to develop new knowledge and skills such as high-value care, systems improvement, population health, and team-based care, which together may be referred to as the Science of Health Care Delivery (SHCD). The ACGME has Havyer et al BMC Medical Education (2017) 17:145 adopted milestones for measuring competence in graduate medical education (GME) [13], and the Association of American Medical Colleges (AAMC) has defined core Entrustable Professional Activities (EPAs) to ensure that medical students are prepared for residency training [14, 15] With this in mind, we aimed to develop a set of SHCD milestones based on published ACGME milestones and corresponding to AAMC EPAs that can be used by medical schools to determine students’ competence in SHCD. We aimed to develop a set of SHCD milestones based on published ACGME milestones and corresponding to AAMC EPAs that can be used by medical schools to determine students’ competence in SHCD These milestones define fundamental expectations within SHCD that are needed for all physicians to help optimize patients’ health outcomes within complex modern healthcare systems.
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