L. Edgar is executive director for milestone development, Accreditation Council for Graduate Medical Education, Chicago, Illinois. S. Roberts is milestones project manager, Accreditation Council for Graduate Medical Education, Chicago, Illinois. N.A. Yaghmour is research associate for milestones evaluation, Accreditation Council for Graduate Medical Education, Chicago, Illinois. A. Leep Hunderfund is assistant professor of neurology, Mayo Clinic, Rochester, Minnesota. S.J. Hamstra is vice president for milestone research and evaluation, Accreditation Council for Graduate Medical Education, Chicago, Illinois. L. Conforti is research associate for milestones evaluation, Accreditation Council for Graduate Medical Education, Chicago, Illinois. E.S. Holmboe is senior vice president for milestone development and evaluation, Accreditation Council for Graduate Medical Education, Chicago, Illinois.
Acad Med. 2018 Jul;93(7):1035-1041. doi: 10.1097/ACM.0000000000002059.
To identify common and overlapping themes among the interpersonal and communication skills (ICS), practice-based learning and improvement (PBLI), professionalism (PROF), and systems-based practice (SBP) milestones of the transitional year and 26 specialties.
In May 2017, milestones were accessed from the Accreditation Council for Graduate Medical Education specialties website. A thematic analysis of the ICS, PBLI, PROF, and SBP milestones was performed to determine unique and common themes across these competencies and across specialties. Keywords from the common program requirements were initially applied as codes to the milestones. Codes were then grouped into common themes.
Twenty-two themes were identified: 15 (68%) were unique to a given competency (3 related to ICS, 4 related to PBLI, 5 related to PROF, and 3 related to SBP), and 7 (32%) appeared in the milestones of more than one core competency. Eleven themes (50%) were used by 20 or more specialties, and 6 themes (27%) by 10 or fewer specialties. No theme was present across all specialties.
The ICS, PBLI, PROF, and SBP milestones contain multiple themes with areas of overlap among these four competencies and substantial variability across specialties. This variability may create differential expectations of residents across specialties, complicate faculty development, and make sharing assessment tools difficult. The thematic analysis provides important insights into how individual specialties interpret and operationalize the ICS, PBLI, PROF, and SBP competency domains and can inform future revisions of milestones to enable harmonization and shared understanding of these competencies across specialties where appropriate.
确定住院医师规范化培训（GME）过渡年和 26 个专业的人际沟通技能（ICS）、实践基础学习与改进（PBLI）、职业精神（PROF）和基于系统的实践（SBP）的里程碑中常见和重叠的主题。
2017 年 5 月，从研究生医学教育认证委员会（ACGME）专业网站获取里程碑。对 ICS、PBLI、PROF 和 SBP 里程碑进行主题分析，以确定这些能力以及各专业之间的独特和共同主题。最初，从共同计划要求中使用关键词作为里程碑的代码。然后将代码分组为共同主题。
确定了 22 个主题：15 个（68%）是特定于特定能力的（与 ICS 相关的 3 个，与 PBLI 相关的 4 个，与 PROF 相关的 5 个，与 SBP 相关的 3 个），7 个（32%）出现在多个核心能力的里程碑中。11 个主题（50%）被 20 个或更多专业使用，6 个主题（27%）被 10 个或更少专业使用。没有一个主题出现在所有专业中。
ICS、PBLI、PROF 和 SBP 里程碑包含多个主题，这些主题涵盖了这四个能力领域之间的重叠领域，并且在各专业之间存在很大的差异。这种差异可能会导致各专业对住院医师的期望不同，使教师发展复杂化，并使评估工具的共享变得困难。主题分析为了解各专业如何解释和操作 ICS、PBLI、PROF 和 SBP 能力领域提供了重要的见解，并可以为未来里程碑的修订提供信息，以在适当的情况下实现各专业之间这些能力的协调和共同理解。
