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2015 ; 7
(1
): 75-80
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English Wikipedia
Milestone-Based Assessments Are Superior to Likert-Type Assessments in
Illustrating Trainee Progression
#MMPMID26217427
Bartlett KW
; Whicker SA
; Bookman J
; Narayan AP
; Staples BB
; Hering H
; McGann KA
J Grad Med Educ
2015[Mar]; 7
(1
): 75-80
PMID26217427
show ga
BACKGROUND: The Pediatrics Milestone Project uses behavioral anchors, narrative
descriptions of observable behaviors, to describe learner progression through the
Accreditation Council for Graduate Medical Education competencies. Starting June
2014, pediatrics programs were required to submit milestone reports for their
trainees semiannually. Likert-type scale assessment tools were not designed to
inform milestone reporting, creating a challenge for Clinical Competency
Committees. OBJECTIVE: To determine if milestone-based assessments better
stratify trainees by training level compared to Likert-type assessments. METHODS:
We compared assessment results for 3 subcompetencies after changing from a
5-point Likert scale to milestone-based behavioral anchors in July 2013. Program
leadership evaluated the new system by (1) comparing PGY-1 mean scores on
Likert-type versus milestone-based assessments; and (2) comparing mean scores on
the Likert-type versus milestone-based assessments across PGY levels. RESULTS:
Mean scores for PGY-1 residents were significantly higher on the prior year's
Likert-type assessments than milestone-based assessments for all 3
subcompetencies (P < .01). Stratification by PGY level was not observed with
Likert-type assessments (eg, interpersonal and communication skills 1 [ICS1] mean
score for PGY-1, 3.99 versus PGY-3, 3.98; P ?=? .98). In contrast,
milestone-based assessments demonstrated stratification by PGY level (eg, the
ICS1 mean score was 3.06 for PGY-1, 3.83 for PGY-2, and 3.99 for PGY-3; P < .01
for PGY-1 versus PGY-3). Significantly different means by trainee level were
noted across 21 subcompetencies on milestone-based assessments (P < .01 for PGY-1
versus PGY-3). CONCLUSIONS: Initial results indicate milestone-based assessments
stratify trainee performance by level better than Likert-type assessments.
Average PGY-level scores from milestone-based assessments may ultimately provide
guidance for determining whether trainees are progressing at the expected pace.
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