Council on Medical Student Education in Pediatrics


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Residents like the Milestones Project!
The Pediatrics Milestones: Initial Evidence for Their Use as Learning Road Maps for Residents. Schumacher DJ et al. Academic Pediatrics 2012; 13(1):40-47.
Reviewed by Caroline Paul

What was the study question?
The purpose of the study was to determine the perceptions of pediatric residents regarding the Pediatric MilestonesProject.

How was the study done?
Forty-eight pediatric residents from all training years at two training programs participated in cognitive interviews. Each resident reviewed one particular Pediatric Milestone Document (PMD). Six residents, 2 from each year, reviewed all eight PMD. Interviews were transcribed and, using inductive methods, coded to result in emerged group themes.

What were the results?
Four themes emerged from resident interviews.

  1. Resident's degree of understanding of the PMD is sufficient.
  2. Residents' understanding of the PMD derives from their own experiences.
  3. Certain qualities of the particular PMD either enable or detract from resident understanding of the PMD.
  4. Residents recognize that PMD involves a developmental learning map. Residents are comfortable placing themselves in the middle of a series of a particular milestone.

What are the implications of the findings?
Under the umbrella of competency-based medical education, the Pediatric Milestones Project has become a new medical educational reality. While faculty are currently busy trying to gain a grasp of this project, it is important from the start, to have insight regarding residents' perceptions and their understanding of the project. This study affords such via its excellent use of cognitive interviewing techniques. Further, the selected residents' quotes offer deep and rich glimpses into residents' learning experiences that can add to our efforts towards competency-based medical education and specifically enable those of us who are working to understand and implement the Milestones Project in our medical educational arenas. Finally, and more globally, this study is a good example of the use of cognitive interviewing with subsequent inductive methods for perhaps other learning topics that may be studied via qualitative method processes.

Editor's note: The goal of this study was to establish if the Milestones documents are of use to one of the intended audiences, namely the pediatric residents. The authors learned that not only do the documents resonate with the residents, but that they are valued as a tool for directing their own learning and assessment - beautiful! (SLB).

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