Curated Milestones Evaluation Exhibit

Assessment of Residents' Knowledge and Skills in Initiation of Insulin Therapy

Leigh M. Eck, MD
University of Kansas

Program Size:  31-100 residents
Program Type:  University-Based
Clinical Setting:   Inpatient Wards, Outpatient/Continuity Clinic


This EPA is designed to assess residents' knowledge and skills related to the initiation of multi-daily injections of subcutaneous insulin therapy in the hospital or ambulatory setting. While this EPA is "assigned" to faculty working with residents on the inpatient endocrine consult rotation, it is generalizable to a variety of other settings with utilization "on the fly" on the general medicine wards as well as in the ambulatory general medicine clinics.

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This evaluation tool was developed by an endocrinologist and hospitalist with subsequent review by the endocrinology division as well as the medical education leadership team. This EPA is linked to curricular milestones in the areas of patient care, medical knowledge, systems based practice, professionalism and interpersonal and communication skills. This linking was done by using a Q-sort methodology.

Lessons Learned

This EPA gets utilized on a much more consistent basis by "assigning" it to a rotation as an expectation as opposed to offering it as an "on the fly" evaluation tool. Setting expectations for completion of this evaluation tool for both the resident and faculty is also critical to ensure compliance on busy clinical rotations.

Faculty Development and Training

The implementation of this tool was reviewed with the endocrine consult faculty as part of a faculty divisional meeting. The concept of an EPA and curricular milestones had previously been reviewed with our faculty as part of a series of Grand Rounds in preparation for the Next Accreditation System.

How Used to Inform Decisions about a Learner's Milestone

Residents are expected to complete a defined number of EPA activities every six months to ensure that direct observation of our residents by faculty is occurring on a regular basis. This evaluation is linked to reporting milestones thus feeds into the aggregate data that we send to the ACGME every six months.

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