Hicks Patricia J, Schumacher Daniel J, Benson Bradley J, Burke Ann E, Englander Robert, Guralnick Susan, Ludwig Stephen, Carraccio Carol
J Grad Med Educ. 2010 Sep;2(3):410-8. doi: 10.4300/JGME-D-10-00126.1.
The Accreditation Council for Graduate Medical Education (ACGME) and the American Board of Pediatrics (ABP) have partnered to initiate the Pediatrics Milestone Project to further refine the 6 ACGME competencies and to set performance standards as part of the continued commitment to document outcomes of training and program effectiveness.
Members of the Pediatrics Milestone Project Working Group searched the medical literature and beyond to create a synopsis of models and evidence for a developmental ontogeny of the elements for 52 subcompetencies. For each subcompetency, we created a series of Milestones, grounded in the literature. The milestones were vetted with the entire working group, engaging in an iterative process of revisions until reaching consensus that their narrative descriptions (1) included all critical elements, (2) were behaviorally based, (3) were properly sequenced, and (4) represented the educational continuum of training and practice.
We have completed the first iteration of milestones for all subcompetencies. For each milestone, a synopsis of relevant literature provides background, references, and a conceptual framework. These milestones provide narrative descriptions of behaviors that represent the ontogeny of knowledge, skill, and attitude development across the educational continuum of training and practice.
The pediatrics milestones take us a step closer to meaningful outcome assessment. Next steps include undertaking rigorous study, making appropriate modifications, and setting performance standards. Our aim is to assist program directors in making more reliable and valid judgments as to whether a resident is a "good doctor" and to provide outcome evidence regarding the program's success in developing doctors.
毕业后医学教育认证委员会（ACGME）与美国儿科学会（ABP）合作启动了儿科学里程碑项目，以进一步完善ACGME的6项能力要求，并设定绩效标准，作为持续致力于记录培训成果和项目有效性的一部分。
儿科学里程碑项目工作组的成员检索了医学文献及其他资料，以创建一份关于52项子能力要素发育个体发生的模型和证据综述。对于每项子能力，我们根据文献创建了一系列里程碑。这些里程碑在整个工作组中进行了审核，经过反复修订，直至达成共识，即其叙述性描述（1）包含所有关键要素，（2）基于行为，（3）顺序恰当，（4）代表了培训和实践的教育连续性。
我们已完成了所有子能力里程碑的第一轮迭代。对于每个里程碑，相关文献综述提供了背景、参考文献和概念框架。这些里程碑提供了对行为的叙述性描述，这些行为代表了在培训和实践的教育连续性中知识、技能和态度发展的个体发生。
儿科学里程碑使我们在有意义的结果评估方面又迈进了一步。下一步包括进行严格研究、做出适当修改并设定绩效标准。我们的目标是协助项目主任就是否一名住院医师是“好医生”做出更可靠、有效的判断，并提供有关该项目培养医生成功与否的结果证据。
