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Milestones in Plastic Surgery: Attending Assessment versus Resident Assessment

Ian Chow, MD; Vu T. Nguyen, MD; Joseph E. Losee, MD, FACS, FAAP; Jesse A. Goldstein, MD; Alexander M. Spiess, MD; Mario G. Solari, MD; J. Peter Rubin, MD; Jeffrey A. Gusenoff, MD
University of Pittsburgh Medical Center
2017-02-14

Presenter: Ian Chow

Affidavit:
I certify that the material proposed for presentation in this abstract has not been published in any scientific journal or previously presented at a major meeting. The submitted work represents the sole work of the resident the work for consideration. The conception and design of the study was split between the submitting resident and the senior author (J.A.G). The resident was responsible for the acquisition of data, analysis and interpretation of the data, and drafted the abstract for submission.

Director Name: Vu T. Nguyen

Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: General Reconstruction

Purpose: The Plastic Surgery Milestone Project was jointly conceived by the ACGME and American Board of Plastic Surgery as a tool to improve granularity in resident feedback. Resident self-evaluations were compared to attending clinical competency committee (CCC) evaluations to gauge resident self-awareness and understanding of the milestones framework.

Methods: Semi-annual evaluations from June 2014-2016 were analyzed and compared with corresponding resident self-evaluations from the 2015-2016 academic year at the University of Pittsburgh Medical Center. The Wilcoxon Rank-Sign test was used to identify any systematic differences between evaluations. Subgroup analysis using the chi-square test was performed to determine factors that may contribute to major assessment disparity (≥1).

Results: Overall, 4,662 milestones across 136 CCC evaluations and 1,713 milestones across 56 resident self-evaluations were available for review. With the exception of PGY-2 residents, residents rated themselves at a significantly lower level in the competencies of medical education and patient care. Post-graduate year, academic year timing, resident pathway, and ACGME competency were associated with major assessment discrepancies (Table).

Conclusions: Overall, residents demonstrate excellent self-awareness of their own abilities, but tend to perceive a lower level of performance in medical knowledge and patient care. Resident specific factors were associated with major assessment discrepancies. This information will serve as a valuable adjunct in the continuing evolution of the Milestone Project while serving as an important basis for enhancing resident feedback.

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