Curated Milestones Evaluation Exhibit

Use of a Facilitated Multi-Source (360) Feedback Tool to Assess Team-Based Competencies

Joseph M. Deutsch, MD
Christiana Care Health System

Program Size: 31-100 residents
Academic Setting: Community-Based
Clinical Setting: Inpatient wards


The evaluation tool is a facilitated multi-source (360) feedback to measure competency in interprofessional teamwork, professionalism, and communication. Our Internal Medicine residency program's inpatient floor teams are partially geographically cohorted on one inpatient unit. After the conclusion of each academic block, a faculty member conducts a one hour facilitated feedback session with representatives from nursing, social work, case management, pharmacy, and physician leadership of that inpatient unit. The faculty facilitator reviews each resident individually with the group and solicits feedback in three domains: effectiveness of working in an interprofessional team (SBP1), professional interactions with an interprofessional team (PROF1), and effective communication with an interprofessional team (ICS2). Pictures of each resident are brought to the meeting to stimulate recall. The faculty facilitator uses language from the ACGME milestones to generate discussion and ultimately determine level of competency. The faculty facilitator will also use peer comparisons to help differentiate low, average, and high performing residents. Decisions about level of competency are made by consensus of the group, with comments provided by all team members as appropriate. Data is recorded by the faculty facilitator using a web based competency evaluation form with the domains listed above (SBP1, PROF1, ICS2). This data is shared with the residents during their semi-annual evaluations, and with the CCC on an ongoing basis.

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Engaging a team of healthcare providers who were interested in evaluating residents. Scheduling a monthly meeting time when everyone would be available to complete the feedback session. Selecting domains of evaluation that an interprofessional team can provide useful feedback on resident competency. Simplifying ACGME milestone language to be approachable and understandable for a broad audience. Modifying our web based competency evaluation form to measure the domains we had chosen.

Lessons Learned

Selecting team members to participate in the feedback session who are not opinionated or observant of resident behavior. While that did not occur in our setting, my assumption is that would lead to difficulty differentiating low, average, and high performing residents. This tool also requires having a faculty facilitator who can engage the team and help differentiate average from above average resident behaviors. The faculty member also has to have a strong understanding of the ACMGE milestones.

Faculty Development and Training

As discussed above, a faculty member will need to have strong interpersonal skills to engage an interprofessional team. The faculty facilitator will also need to have a strong understanding of the ACGME milestones, and the differentiating factors between each level of competency.

How Used to Inform Decisions about a Learner's Milestone

Explained above. This tool directly links to the current ACGME milestones. Discussion is based on the language from ACGME milestones directly. Although the language is often simplified during discussion, the key wording from each milestone is preserved when determinations of level of competency are made.

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