Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA 94305, United States.
Department of Physical Medicine and Rehabilitation, Medical College of Wisconsin, Madison, WI 53726, United States.
Pain Med. 2023 Jul 5;24(7):750-757. doi: 10.1093/pm/pnad014.
To describe the process of revising the Pain Medicine Milestones 1.0 and implementing changes into the Pain Medicine Milestones 2.0 along with implications for pain medicine trainees.
Competency-based medical education has been implemented in graduate medical education, including pain medicine. Milestones 1.0, introduced by the Accreditation Council for Graduate Medical Education (ACGME), has been used to assess learners in six competencies and respective sub-competencies. Recognizing areas for improvement in Milestones 1.0, the ACGME initiated the process of Milestones 2.0 and a working group was created to execute this task for pain medicine. The working group discussed revisions; consensus was sought when changes were introduced. Final milestones were agreed upon and made available for public comment prior to publication.
Redundant sub-competencies were either merged or eliminated, reducing the number of sub-competencies. A maximum of three rows representing skill, knowledge, behavior and attitude were included for each sub-competency. Harmonized Milestones, aligning with other specialties in a predetermined ACGME framework, were adopted and modified to meet the needs of pain medicine. A supplemental guide was developed to assist educators in implementation of Milestones 2.0 and assessment of trainees.
The intent of the Milestones 2.0 was to create an improved tool that is comprehensive, easier to utilize, and of increased value for pain medicine training programs. It is expected that implementation of Milestones 2.0 will streamline pain medicine trainee assessments by educators and prepare trainees for the future practice of pain medicine while serving to be the foundation of an iterative process to match the evolution of the specialty.
描述修订疼痛医学里程碑 1.0 并将变更实施到疼痛医学里程碑 2.0 中的过程，同时介绍对疼痛医学受训者的影响。
基于能力的医学教育已在研究生医学教育中实施，包括疼痛医学。ACGME 引入的里程碑 1.0 已用于评估六个能力及其各自的子能力的学习者。认识到里程碑 1.0 的改进领域，ACGME 启动了里程碑 2.0 的进程，并成立了一个工作组来执行疼痛医学的这项任务。工作组讨论了修订意见；在引入变更时寻求了共识。最终里程碑达成一致，并在发布前供公众发表意见。
冗余的子能力要么合并，要么删除，从而减少了子能力的数量。每个子能力最多包含三行代表技能、知识、行为和态度。采用并修改了与其他专业相协调的统一里程碑，以满足疼痛医学的需求。制定了一份补充指南，以协助教育工作者实施里程碑 2.0 和评估受训者。
里程碑 2.0 的目的是创建一个更全面、更易于使用且对疼痛医学培训计划更有价值的改进工具。预计实施里程碑 2.0 将简化教育工作者对疼痛医学受训者的评估，并为未来疼痛医学实践做好准备，同时也是一个迭代过程的基础，以适应专业的发展。
