Robust Training Programme Research Articles

EFFECT OF FINANCIAL MOTIVATION AS A TOOL FOR INCREASING EMPLOYEE EFFICIENCY: A STUDY OF LARFAGE CEMENT COMPANY EWEKORO

This research provides an in-depth examination of the impact of financial motivation on enhancing employee efficiency, utilizing the Larfage Cement Company in Ewekoro, Ogun State, Nigeria, as a case study. The findings strongly suggest a robust relationship between financial motivation and employee efficiency, underscoring the substantial correlation between employee motivation and broader organizational performance metrics. Moreover, the study scrutinizes the multifaceted challenges stifling the effectiveness of employee motivation strategies within organizations. It brings attention to the constant dynamism of the labor market and the crucial need for implementing comprehensive motivational systems that align seamlessly with overarching organizational objectives. The research notably underscores the need for industry leaders to strategically prioritize the integration of motivational techniques that contribute positively to the work environment and enhance productivity. It places significant emphasis on the instrumental role of equitable remuneration policies, promotions based on merit, robust staff training and development programs, and fostering supportive employee-management relationships. By doing so, the research affirms the centrality of these elements in shaping employee motivation, and, consequently, organizational performance. Overall, the study presents a compelling argument for the necessity of a strategic, well-structured approach to employee motivation to optimize efficiency and productivity within the manufacturing industry.

The Role of Information and Communiication Technology Combating Crime in Nigeria in The Post Covid 19 Era: A Study of the Nigeria Police Force, Lagos State Command

The study seeks to examine the impact of Information and Communication Technology (ICT) on combating crime by the security forces in the wake of corona virus pandemic with special reference to the Nigeria Police Force (NPF). Within the framework of cybernetic theory, this study adopts the descriptive survey method to examine the relationship between the two variables under investigation. Multi stage sampling technique was used to draw a sample size of three hundred (300) participants for the study. Data were collected from the sampled population, and formulated hypotheses were tested using Pearson Product Moment Correlation Coefficient (PPMCC) statistical tool. The finding of the study reveals that there is a significant relationship between the use of ICT and the effort by the police force to effectively combat crime in Nigeria. The study also discovers that the use of ICT in the fight against crime by the NPF is faced with some challenges, which includes among others; lack of infrastructure, lack of adequate training, uncooperative attitude of ICT service providers and lack of inter-agency cooperation. The paper in conclusion, recommends that the NPF should improve on the usage of ICT especially during this post COVID-19 era by providing a robust training program for her personnel on the usage of ICT in combating crime, the government should provide adequate infrastructure to enhance effective application of ICT in crime fighting and an effective collaboration between ICT service providers and the NPF in fighting crime in Nigeria.

The Kaiser Permanente Northern California COVID-19 physician redeployment experience: Redeploying physicians to meet the demands of the pandemic

This paper describes a redeployment programme developed by Kaiser Permanente Northern California (KP NCAL) to meet physician staffing needs during five COVID-19 surges in Northern California. By leveraging two existing programmes, creating a flexible system of redeployment levels, and supporting the system with a robust training programme, the physician redeployment programme effectively addressed physician staffing needs, maximised excellent patient care, and supported KP NCAL physicians during the pandemic. The programme delivered care to over 131,000 outpatients with COVID-19 infection and redeployed physicians into more than 800 inpatient shifts.

Academic Careers in Advocacy: Aligning Institutional Values Through Use of an Advocacy Portfolio.

Academic children's hospitals must embrace advocacy as a central component of their missions to discover new knowledge and improve the health of the communities and patients they serve. To do so, they must ensure faculty have both the tools and the opportunities to develop and articulate the work of advocacy as an academic endeavor. This can be accomplished by integrating the work of advocacy at the community and policy-change levels into the traditional value systems of academic medicine, especially the promotions process, to establish its legitimacy. Academic pediatric institutions can support this transformation through robust training and professional development programs and establishing opportunities, resources, and leadership positions in advocacy. The adoption of an advocacy portfolio can be used to align these activities and accomplishments to institutional values and promotion. This alignment is crucial to supporting the advocacy work of pediatricians at a time in which community engagement and systems and policy change must be added to professional activities to ensure optimal outcomes for all children.

The power of feedback: Implementing a comprehensive hand hygiene observer program

Hand hygiene (HH) is a fundamental component of infection prevention within all healthcare settings. We implemented a hospital-wide program built on overt HH observation, real-time feedback, and thematic analysis of HH misses. A robust observer training program was established to include foundational training in the WHO's My Five Moments of HH. Observational data from 2011 to 2019 were analyzed by unit, provider type, and thematic analyses of misses. During the study period, we conducted 160,917 hospital-wide observations on 29 units (monthly average of 1,490 observations). Institutional compliance remained above 95% from 2013 to 2019. Thematic analysis revealed "touching self" and "touching phone" as common, institution-wide reasons for HH misses. Overt observations facilitated communication between HH program and healthcare staff to better understand workflow and educate staff on HH opportunities. This program is an integral part of the Infection Prevention team and has been deployed to collect supplemental data during clusters and outbreaks investigations. In addition to having rich HH data, successes of this program, include increased awareness of IPC practices, enhanced communication about patient safety, enriched dialog and feedback around HH misses, and relationship building among program observers, unit staff and leaders.

From Haphazard to a Sustainable Normothermic Regional Perfusion Service: A Blueprint for the Introduction of Novel Perfusion Technologies.

Normothermic Regional Perfusion (NRP) has shown encouraging clinical results. However, translation from an experimental to routine procedure poses several challenges. Herein we describe a model that led to the implementation of NRP into standard clinical practice in our centre following an iterative process of refinement incorporating training, staffing and operative techniques. Using this approach we achieved a four-fold increase in trained surgical staff and a 6-fold increase in competent senior organ preservation practitioners in 12 months, covering 93% of the retrieval calls. We now routinely provide NRP throughout the UK and attended 186 NRP retrievals from which 225 kidneys, 26 pancreases and 61 livers have been transplanted, including 5 that were initially declined by all UK transplant centres. The 61 DCD(NRP) liver transplants undertaken exhibited no primary non-function or ischaemic cholangiopathy with up to 8 years of follow-up. This approach also enabled successful implementation of ex situ normothermic liver perfusion which together with NRP contributed 37.5% of liver transplant activity in 2021. Perfusion technologies (in situ and ex situ) are now supported by a team of Advanced Perfusion and Organ Preservation Specialists. The introduction of novel perfusion technologies into routine clinical practice presents significant challenges but can be greatly facilitated by developing a specific role of Advanced Perfusion and Organ Preservation Specialist supported by a robust education, training and recruitment programme.

The impact of age and maturation on physical performance capacities in emerging adolescent surfing athletes: An argument for off-water training

Surfing is a high intensity intermittent sport, rapidly increasing in popularity in recent years. Surfing athletes who possess holistic physical performance capabilities, for example; strength, power, dynamic balance and flexibility, are better able to respond to the dynamic and variable nature of competition. Talent identification (TID) and long-term athlete development (LTAD) processes must consider the physical capacities necessary for performance and the impact of maturation. This study aimed to identify the physical performance capacities of state level adolescent surfers and explore their association with age and maturation. Participants (13.68 ± 1.57 years, 159.54 ± 12.33 cm, 50.07 ± 12.25 kg) were recruited from the Surfing Western Australia (WA) High Performance Pathway (HPP). Athletes completed a TID testing battery including anthropometrics (height, sitting height, body mass, arm span, sum of 7 skinfolds), flexibility (sit and reach), lower body power (vertical and broad jump) and strength (isometric mid-thigh pull; IMTP), dynamic balance (time to stabilisation; TTS) and sensorimotor ability and stability (Athletic Ability Assessment; AAA). Findings demonstrated whilst many physical performance capacities improved with advanced age and maturation, relative lower body strength, dynamic balance and several components of the AAA did not. Further, physical performance capacities were similarly associated with both maturity and age, except total AAA, which was significantly associated with maturation but not age. In conclusion, these data highlight inefficiencies in the current physical preparation of emerging adolescent state-level surfing athletes and highlight the need for a more robust training programme to maximise athletic potential, including structured off-water training.

The impact of neonatologist performed echocardiography in an Italian neonatal unit.

The main goal of neonatologist performed echocardiography is to timely assess hemodynamic changes in order to properly manage unsteady neonates. Detailed structural heart assessment remains the domain of pediatric cardiologists. Nonetheless, many neonatologists take on an additional role in diagnosis of congenital heart defects, mostly compelled by the lack of in-house pediatric cardiology services. The experience of neonatologist performed echocardiography in an Italian neonatal unit was reported and the risk benefit profile of this practice was discussed. We retrospectively reviewed the echocardiograms undertaken by the neonatologist on infants admitted to the neonatal unit and postnatal ward of the Hospital San Pio in Benevento, over a 2-year period. Details of scans and concordance between neonatologist and cardiologist were analyzed. A total of 160 echocardiographic studies were done by the neonatologist on 136 infants. The ECG was requested in a minority of infants. The most common reason for performing the echocardiogram was admission to the neonatal care unit. Around half of the echocardiograms were normal. The remaining scans resulted in functional and structural abnormalities, transitional changes, and doubtful findings. Cardiac anomalies were significantly more likely found in cases of echocardiograms performed for fetal indications. Only 28 patients were eventually referred to the cardiology services. The inter-rater agreement was satisfactory. The hemodynamic assessment of sick infants, as well as triaging and referral of neonates with structural heart diseases are valuable advantages of the echocardiography run by neonatologists.Collaboration with pediatric cardiologists and robust training and accreditation programs are essential to ensure safety and quality service.

35 Using a New Quality Registry System to Improve Data Completeness for a National Burn Registry

IntroductionThe burn care community has demonstrated a long-standing commitment to quality of care, improved outcomes, and research by collecting and sharing clinical data through burn registries. The key to optimizing the value creation from these registries is data quality. In 2019 a new registry platform incorporating the latest, standardized, data definitions and sophisticated audit controls was piloted with 12 burn centers. The following year it was introduced to the broader burn care community along with a robust registrar education and training program. We sought to evaluate the effect of this new system on quality of data collection.MethodsWe compared data from 27 centers that collected data on the new system against their data collected on prior registry systems. We analyzed 26 data elements, across four different variable categories (Admissions (n=6), Demographics (n=5), Injury (n=10), and Outcomes(n=5)) that have been consistently collected over time, for data completeness. A two-proportion z test was used to assess statistical significance of differences in data completeness rates.ResultsThe 27-center cohort entered data on 4,524 inpatient burn admissions between January 1, 2020 and June 30th 2021 and 7,259 admissions between July 1st, 2019 and June 30th, 2020 in their legacy system. The data elements were harmonized to maximize longitudinal comparability.When comparing data from the same centers but using different registry software (graphic 1) 16 of 26 variables profiled had a higher percentage of completeness in the new registry system (all statistically significant), 5 variables were statistically significantly lower, and 5 variables were not significantly different. Overall, this subset of data elements showed a 14% improvement in data completeness between the new and legacy systems (90% vs 75%).ConclusionsThe development of a clinical registry requires significant commitment and leadership from the healthcare association and broader clinical community. The resources and effort that the burn community has expended to improve data quality has produced important gains in data quality with the introduction of a new, high-quality registry. The burn care community should continue to emphasize education, innovation, and collaboration to collect the highest quality data at the lowest burden from all burn centers.

Barriers to recruitment into emergency department-initiated palliative care: a sub-study of a multi-site, randomized controlled trial

BackgroundEmergency department (ED) visits among older adults are common near the end of life. Palliative care has been shown to reduce ED visits and to increase quality of life among patients, but recruitment into these programs is often challenging. This descriptive analysis explores the barriers to enrolling seriously ill patients scheduled for discharge from the ED into palliative care research.MethodsThis descriptive sub-study aims to assess the reasons why patients with advanced illness scheduled for discharge home from 11 EDs across the United States decline to participate in Emergency Medicine Palliative Care Access (EMPallA), a Phase IV randomized controlled trial (RCT) comparing two modes of palliative care delivery. Our aim was to understand why patients decline to enroll to improve future recruitment rates and expand care for patients discharged home from the ED. Research coordinators documented reasons that patients declined to enroll in the larger EMPallA trial; reasons for refusing participation were independently analyzed by two researchers to identify overarching themes.ResultsEnrollment rate across all sites was 45%; of the 504 eligible patients who declined participation, 47% (n = 237) declined for reasons related to illness severity. 28% of refusals (n = 143) were related to the mode of palliative care delivery, while 24% (n = 123) were due to misconceptions or stigma related to palliative care. Less commonly, patients refused due to general research barriers (16.5%), family/caregiver barriers (11.7%), and physician-related barriers (< 1%).ConclusionsPatients with advanced illnesses presenting to the ED often refuse to participate in palliative care research due to the severity of their illness, the mode of care delivery, and misconceptions about palliative care. In contrast with other studies, our study found minimal physician gatekeeping, which may be the result of both changing attitudes toward palliative care and the nature of the ED setting. Robust training programs are crucial to overcome these misconceptions and to educate patients and providers about the role of palliative care. Future palliative care programs and study designs should recognize the burden this vulnerable population endures and consider alternative modes of care delivery in an effort to increase participation and enrollment.Clinical trials registrationNCT03325985, October 30, 2017.

Evaluating the Security Posture and Protection of Critical Assets of Industrial Control Systems in Zambia

The number of successful attacks on vital infrastructure has increased, as has the sophistication of the attacks. Many cybersecurity strategies include traditional best practices, but they frequently overlook organizational circumstances and unique critical infrastructure protection requirements. The goal of this qualitative multiple case research was to look into the cybersecurity tactics employed by IT managers and compliance officers to protect critical infrastructure from cyber threats. The participants in this study were IT managers and compliance officials from four Zambian case organizations. The conceptual framework was based on the routine activity theory published by criminologists Cohen and Felson in 1979. Interviews with two IT managers, three compliance officers, and 25 papers relating to cybersecurity and policy governance were used to gather data. Four significant themes emerged from data triangulation: the need for a robust worker training program, prioritizing infrastructure resiliency, the importance of security awareness, and the importance of organizational leadership support and investment. This research uncovered essential tactics that can help OT and compliance professionals enhance their cybersecurity strategy, which can help reduce successful assaults on critical infrastructure. The study findings will contribute to positive social change through an exploration and contextual analysis of cybersecurity strategy with situational awareness of OT practices to enhance cyber threat mitigation and inform business processes.

Development and evaluation of a novel training program to build study staff skills in equitable and inclusive engagement, recruitment, and retention of clinical research participants.

Adequate equitable recruitment of underrepresented groups in clinical research and trials is a national problem and remains a daunting challenge to translating research discoveries into effective healthcare practices. Engagement, recruitment, and retention (ER&R) training programs for Clinical Research Professionals (CRPs) often focus on policies and regulations. Although some training on the importance of diversity and inclusion in clinical research participation has recently been developed, there remains a need for training that couples critical equity, diversity, and inclusion (EDI) concepts with skill development in effective recruitment and retention strategies, regulations, and best practices. We developed the ER&R Certificate program as a holistic approach to provide Duke University CRPs the opportunity to build competency in gap areas and to increase comfort in championing equitable partnerships with clinical research participants. The thirteen core and elective courses include blended learning elements, such as e-learning and wiki journaling prompts, to facilitate meaningful discussions. Pre- and post-assessments administered to CRP program participants and their managers assessed program impact on CRP skills in ER&R tasks and comfort in equitable, diverse, and inclusive engagement of clinical research participants. Results from the first two cohorts indicate that CRPs perceived growth in their own comfort with program learning objectives, especially those centered on participant partnership and EDI principles, and most managers witnessed growth in competence and responsibility for ER&R-related tasks. Results suggest value in offering CRPs robust training programs that integrate EDI and ER&R training.

Neurosurgery at UT Southwestern Medical Center: 1956-2020.

The history of neurosurgery at UT Southwestern Medical Center in Dallas, Texas, is reviewed. Kemp Clark, MD, started the academic neurosurgical practice at Parkland Hospital in 1956. Clark developed a robust training program that required the resident to operate early. In 1972, the Dallas Veterans Affairs Hospital was added to the training program. Duke Samson, MD, became chair in 1988. He emphasized technical excellence and honest reporting of surgical outcomes. In 1989, Zale Lipshy University Hospital opened and became a center for neurosurgical care, and Hunt Batjer, MD, became chair in 2012. The program expanded significantly. Along with principles established by his predecessors, Batjer emphasized the need for all neurosurgeons to engage the community and to be active in policy leadership through local and national organizations. During his tenure, the pediatric neurosurgery group at Children's Medical Center Dallas was integrated with the department, and a multidisciplinary spine service was developed. In 2014, the Peter O'Donnell Jr. Brain Institute was established, and the William P. Clements Jr. University Hospital opened. For 64 years, UT Southwestern Medical Center has been fertile ground for academic neurosurgery, with a strong emphasis on excellence in patient care.

Developing a Standardized Method for Clinical Staff Training, Education, and Competency.

Clinical skill competency maintenance is a regulatory and quality requirement, making it top priority for healthcare organizations. Staff having the proper clinical competencies to provide high-quality care begins with nursing orientation and continues with the maintenance of annual skill competency. Building a robust training and clinical competency program requires collaboration between nursing education and nursing leadership. This project describes a model for nursing orientation and continued training in an ambulatory care setting.

The Legacy of the Wright State University Aerospace Medicine Residency Program.

INTRODUCTION: In the mid-1970s, NASA required a robust training program for physicians responsible for the medical needs of the Shuttle astronauts. Personnel at NASA worked closely with academicians and subject matter experts at Wright State University (WSU) to develop and establish a residency program in aerospace medicine. This academic training program was initiated in 1978 and closed in 2018. The objective of this historical piece is to catalog, for posterity, the impact this training program has had on national and international human spaceflight and aviation. METHODS: A thorough review of all available historical documents and oral histories provided by contemporaries were reviewed in detail, including a search of every available residents thesis and all available historical documents and reports at WSU and NASA Headquarters. RESULTS: Over the past 40 yr, WSU has graduated 172 individuals with an M.S. degree focused on aerospace medicine, of which 84 were residents. Nearly 50 of these residents have worked closely with NASA. Many others became integrated into academia, the aviation industry, or international space programs. DISCUSSION: With the growth in interest for government and commercial spaceflight, the field of aerospace medicine is poised to grow. Although it is not well known outside of the Aerospace Medicine community, the legacy of this pioneering, 40-yr civilian-based program is of significant value. If not recorded in an easily locatable and accessible manner, many of the challenges and outcomes from this residency could be lost until future generations have to spend the money, time, and effort to relearn them. Doarn CR, Shimada K, Shepanek M. The legacy of the Wright State University Aerospace Medicine Residency program. Aerosp Med Hum Perform. 2021; 92(9):744750.

Victor Almon McKusick: In the footsteps of Mendel and Osler.

Victor Almon McKusick (VAM) is widely recognized as the father of the field of medical genetics. He established one of the first medical genetics clinics in the United States at Johns Hopkins in 1957 and developed a robust training program with the tripartite mission of education, research, and clinical care. Thousands of clinicians and scientists were educated over the years through the Short Course in Medical and Molecular Genetics, which VAM founded with Dr. Thomas Roderick in 1960. His Online Mendelian Inheritance in Man (OMIM), a catalog of human genes and genetic disorders, serves as the authoritative reference for geneticists around the globe. Throughout his career he was an advocate for mapping the human genome. He collaborated with Dr. Frank Ruddle in founding the International Human Gene Mapping Workshops in the early 70's and was an avid proponent of the Human Genome Project. He was the founding President of the Human Genome Organization and a founding editor of the journal Genomics. His prodigious contributions to the field of medical genetics were recognized by multiple honors, culminating with the Japan Prize in 2008.

The influence of a Sprint optimization and training intervention on time spent in the electronic health record (EHR).

ObjectiveWe report the influence of Sprint electronic health record (EHR) training and optimization on clinician time spent in the EHR.Materials and MethodsWe studied the Sprint process in one academic internal medicine practice with 26 providers. Program offerings included individualized training sessions, and the ability to clean up, fix, or build new EHR tools during the 2-week intervention. EHR usage log data were available for 24 clinicians, and the average clinical full-time equivalent was 0.44. We used a quasi-experimental study design with an interrupted time series specification, with 8 months of pre- and 12 months of post-intervention data to evaluate clinician time spent in the EHR.ResultsWe discovered a greater than 6 h per day reduction in clinician time spent in the EHR at the clinic level. At the individual clinician level, we demonstrated a time savings of 20 min per clinician per day among those who attended at least 2 training sessions.DiscussionWe can promote EHR time savings for clinicians who engage in robust EHR training and optimization programs. To date, programs have shown a positive correlation between participation and subjective EHR satisfaction, efficiency, or time saved. The impact of EHR training and optimization on objective time savings remains elusive. By measuring time in the EHR, this study contributes to an ongoing conversation about the resources and programs needed to decrease clinician EHR time.ConclusionsWe have demonstrated that Sprint is associated with time savings for clinicians for up to 6 months. We suggest that an investment in EHR optimization and training can pay dividends in clinician time saved.

Workforce Readiness Training: A Comprehensive Training Model That Equips Community Health Workers to Work at the Top of Their Practice and Profession.

Background: Recent reports have recognized that only 20 percent of health outcomes are attributed to clinical care. Environmental conditions, behaviors, and social determinants of health account for 80 percent of overall health outcomes. With shortages of clinical providers stressing an already burdened healthcare system, Community Health Workers (CHWs) can bridge healthcare gaps by addressing these nonmedical factors influencing health. This paper details how a comprehensive training model equips CHWs for workforce readiness so they can perform at the top of their practice and profession and deliver well-coordinated client/patient-centered care.Methods: Literature reviews and studies revealed that training CHWs alone is not sufficient for successful workforce readiness, rather CHW integration within the workforce is needed. Consequently, this comprehensive training model is developed for CHWs with varying skill levels and work settings, and supervisors to support organizational readiness and CHW integration efforts. A systematic training program development approach along with detailed implementation methods are presented. Continuing education sessions to support CHW practice and Organizational Readiness Training for supervisors, leadership and team members directly engaged with CHWs in the workplace are also discussed. CHWs were involved in all phases of the research, development, implementation, and actively serve in evaluations and curriculum review committees.Results: Components of the comprehensive training model are presented with an emphasis on the core CHW training. Two CHW training tracks are offered using three delivery modalities. Process measures with student learning objectives, outcome measures developed using the Kirkpatrick model to capture attitude, perceptions, knowledge acquisition, confidence, behavior, and overall experience, and impact stories by two CHWs are presented. Lessons learned from the implementation of the training program are discussed in three categories: Practice-driven curricula, student-centered training implementation, and adaptations in response to COVID-19 pandemic.Conclusion: This comprehensive training model recognizes that training CHWs in a robust training program is key as the demand for well-rounded CHWs increases. Furthermore, a comprehensive training program must include training for supervisors, leadership, and team members working directly with CHWs. Such efforts strengthen the CHW practice and profession to support the delivery of well-coordinated and holistic client/patient-centered care.

Implementation of point-of-care blood gas testing at a large community hospital: Cost analysis, sepsis bundle compliance, and employee engagement.

Introduction/BackgroundPoint-of-care testing (POCT) platforms support patient-centered approaches to health care delivery and may improve patient care. We evaluated implementation of a POCT platform at a large, acute care hospital in the Midwestern United States.MethodsWe used lactate testing as part of a sepsis bundle protocol to evaluate compliance and mortality outcomes. Respiratory team members were surveyed to assess perception of efficiency, ease of use, timely patient care, and overall engagement with the POCT system. Annualized cost per test of a benchtop analyzer and a POCT platform were compared across 3 years for each platform.ResultsLactate testing volume increased from 61% to 91%, which was associated with improved sepsis bundle protocol compliance. Employees reported high levels of engagement, improvements in efficiency and time savings, and better patient care with POCT. Average cost per test was $10.02 for the benchtop system and $6.21 for the POCT platform. POCT saved our institution $88,476 annually in labor costs.DiscussionCombined with a robust training program emphasizing the use of lactate testing in the context of the overall clinical picture, POCT enabled adherence to the sepsis bundle protocol and may have contributed to lower mortality. Additionally, the COVID-19 pandemic has provided us with unanticipated benefits of using POCT; it has enhanced our ability to deal with stringent infectious disease protocols, saving time and minimizing patient and staff exposure.ConclusionsImplementation of a POCT platform was associated with improved compliance to our sepsis protocol, reduced sepsis mortality, high employee engagement, and cost savings.

Competencies and Milestones for Bioethics Trainees: Beyond ASBH’s Healthcare Ethics Consultant Certification and Core Competencies

Clinical ethics training programs are responsible for preparing their trainees to be competent ethics consultants worthy of the trust of patients, families, surrogates, and healthcare professionals. While the American Society for Bioethics and Humanities (ASBH) offers a certification examination for healthcare ethics consultants, no tools exist for the formal evaluation of ethics trainees to assess their progress toward competency. Medical specialties accredited by the Accreditation Council for Graduate Medical Education (ACGME) use milestones to report trainees’ progress along a continuum of professional development as a means of “operationalizing and implementing” medical competencies. Utilizing the Core Competencies for Healthcare Ethics Consultation and the ACGME and American Board of Pediatrics’ (ABP) Pediatric Milestones Project, we developed milestones for 17 subcompetencies in clinical ethics consultation and academic bioethics. As the field of clinical ethics becomes more standardized, such tools will be needed to promote the development of robust training programs and to certify that their graduates are competent practitioners.