Milestones, EPAs, and NAS

NAS Resources

Next Accreditation System

AAIM is gathering tools and resources to assist faculty with the implementation of the Next Accreditation System (NAS). The topics below features forms shared by your colleagues. Forms are available only in the original format provided.

Q Sort and 5-Step Assessment Tools

These blank templates from Southern Illinois University (SIU) can be used to facilitate a Q sort for establishing priorities and reaching consensus around the candidate curricular milestones that best inform a particular EPA.

Also, the following are five steps to create an end of rotation Curricular Milestone assessment tool. This tool was modified from an original created by SIU before the publication of the curricular milestones.

Evaluation Forms

Resident Evaluation Forms Using RIME Score 1 to 4

Using these forms, a resident evaluation committee can decide on three questions for each of the Core Competency measures. These questions are chosen to generate the appropriate level of progress for the respective year of training. The questions are answered by direct observation, discussion during rounds, during video or simulation labs, or 1:1 mentor resident interactions, and given a RIME score 1-4.

PGY Level-Specific Self-Assessment Forms

Program directors can use milestones based self-evaluation forms for their residents prior to semi-annual meetings. Moreover, these forms can assist program directors in determining which milestones are most important to the programs.

Example self-assessment forms have been developed by APDIM members:

Milestone-based Evaluation Form

AAIM Education Redesign Precourse Q-Sort Activity

As part of the 2013 APDIM Spring Education Precourse, participants each completed a q-sort exercise by linking milestones to end-of-training entrustable professional activities (EPAs).

For the purposes of this activity, the AAIM Education Redesign Committee assigned 22 specific curricular milestones for each EPA. The game board, printing template, and templates for milestones playing cards can be downloaded for faculty use.

Templates for Milestones Playing Cards (Labeled by EPA):

Tools for Creating Q-Sort Exercise:

Instructions for Creating Q-Sort Playing Cards Using Post-it Notes:

  1. Print the blank template on a standard sheet of paper
  2. Place blank post-it notes onto each square of the template (notes must be placed in the same direction)
  3. Feed the template with Post-it notes into printer (make sure side with adhesives is fed first)
  4. Print document with assigned 22 milestones (labeled by EPA) onto the sheet with Post-it notes created in step 2

The template sheets are designed for 1-1/2 x 2 Post-it notes.

2013 APDIM Spring Education Precourse

"Resident Assessment Using EPAs: Helping Program Directors Design Evaluation Systems to Meet Reporting Requirements for the ACGME Next Accreditation System (NAS)"

A video of the precourse is posted on the APDIM Forum for Milestones Innovation and Collaboration on AAIM Connect. This community is open only to AAIM members. Note that the file is very large and make take several minutes to download.

Four Types of Evaluation Forms Across R1, R2, and R3

Wright-Patterson Medical Center has compiled evaluation forms for Ambulatory Medicine, Consultation Medicine, Inpatient Medicine and Night Float distributed among R1, R2, and R3.

Ambulatory Medicine

Consultation Medicine

Inpatient Medicine

Night Float