1. Milestones Evaluation Tools Gregory J. Zipfel, MD

2. Resident Evaluations Options –Likert Scale Evaluations + Milestones Very lengthy –Milestones alone Lengthy Not recommended by ACGME (reporting tool) –Develop Milestone-based evaluations Neurosurgery chose this option

3. Milestone-based Evaluations Milestones Working Group –Goals Make our assessment tools Milestone-specific

4. Milestone-based Evaluations Milestones Working Group –Goals Make our assessment tools Milestone-specific Assist the PD and PC in drafting milestone levels prior to CCC meeting

5. Milestone-based Evaluations Milestones Working Group –Goals Make our assessment tools Milestone-specific Assist the PD and PC in drafting milestone levels prior to CCC meeting Provide consistency in evaluation of residents between programs

6. Milestone-based Evaluations Milestones Working Group –Method Avoid numerical scales

7. Milestone-based Evaluations Milestones Working Group –Method Avoid numerical scales Utilize the language of the milestones

8. Milestone-based Evaluations Milestones Working Group –Method Avoid numerical scales Utilize the language of the Milestones Include the opportunity for narrative comment

9. Example

10. 3 evaluation questions? Example

11. 3 evaluation questions? No! – covered by 1 Example

12. Example – Evaluation question Work-up and treatment plan for patients with ischemic and hemorrhagic stroke  Not observed  Unsatisfactory  Initiates work-up  Formulates work-up and treatment plan  Formulates plan for patient with co- morbidities ✓

13. ✓ Example

14. Impressions to Date Establishing a baseline for each resident has been difficult; likely lacks accuracy High burden on faculty –Baseline evaluations – time consuming –Rotation evaluations – 50% more compared to past system High burden on PC –Implementing new evaluation process –Translating Milestone-based evaluations to Milestones currently manual process Extra burden on PD –Implementing new evaluation process –Pre-CCC / CCC meeting preparations

15. Impressions to Date Value of Milestones likely to come gradually over years –Accuracy of individual resident evaluations will improve over time –Faculty will become more familiar with items included in Milestones –Institutional and national comparative data will become available over time

16. Thanks