Boston, Mass.; and New Orleans, La. From the Division of Plastic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School; and the Division of Plastic Surgery, Louisiana State University.
Plast Reconstr Surg. 2015 Jul;136(1):181-187. doi: 10.1097/PRS.0000000000001368.
The Accreditation Council for Graduate Medical Education Next Accreditation System milestones were implemented for plastic surgery programs in July of 2014. Forward progress through the milestones is an indicator of trainee-appropriate development, whereas regression or stalling may indicate the need for concentrated, targeted training.
Online software at www.surveymonkey.com was used to create a survey about the program's approaches to milestones and was distributed to program directors and administrators of 96 Accreditation Council for Graduate Medical Education-approved plastic surgery programs.
The authors had a 63.5 percent response rate (61 of 96 plastic surgery programs). Most programs report some level of readiness, only 22 percent feel completely prepared for the Next Accreditation System milestones, and only 23 percent are completely satisfied with their planned approach for compliance. Seventy-five percent of programs claim to be using some form of electronic tracking system. Programs plan to use multiple tools to capture and report milestone data. Most programs (44.4 percent) plan to administer evaluations at the end of each rotation. Over 70 percent of respondents believe that the milestones approach would improve the quality of resident training. However, programs were less than confident that their current compliance systems would live up to their full potential.
The Next Accreditation System has been implemented nationwide for plastic surgery training programs. Milestone-based resident training is a new paradigm for residency training evaluation; programs are in the process of making this transition to find ways to make milestone data meaningful for faculty and residents.
美国毕业后医学教育认证委员会（Accreditation Council for Graduate Medical Education，ACGME）的下一阶段认证系统里程碑于 2014 年 7 月在整形外科培训项目中实施。通过里程碑的前进是学员适当发展的指标，而倒退或停滞可能表明需要集中、有针对性的培训。
使用在线软件 www.surveymonkey.com 创建了一个关于该项目里程碑方法的调查，并分发给 96 个经美国毕业后医学教育认证委员会（Accreditation Council for Graduate Medical Education，ACGME）批准的整形外科培训项目的主任和管理人员。
作者的回复率为 63.5％（96 个整形外科项目中的 61 个）。大多数项目报告了某种程度的准备就绪，只有 22％的项目认为自己完全为下一阶段认证系统里程碑做好了准备，只有 23％的项目对其符合规定的计划方法完全满意。75％的项目声称正在使用某种形式的电子跟踪系统。项目计划使用多种工具来获取和报告里程碑数据。大多数项目（44.4％）计划在每个轮转结束时进行评估。超过 70％的受访者认为里程碑方法将提高住院医师培训的质量。然而，项目对其当前的合规系统能否充分发挥潜力缺乏信心。
下一阶段认证系统已在全国范围内为整形外科培训项目实施。基于里程碑的住院医师培训是住院医师培训评估的新范式；项目正在进行过渡，以找到使里程碑数据对教师和住院医师有意义的方法。
