Milestones (points per behavior)
Pre-Emergent	Emerging (1 point)	Acquiring (2 points)	Mastering (3 points)
1. Identifies the pertinent facts of a clinical case (MK).
Does not note case information	Repeats Initial History (IH) with little or no editing. OR Restates IH, but omits important information. Does not identify pertinent clinical facts (i.e., no mention of pertinent positives/negatives, risk factors, social/cultural factors, etc.)	Restates IH in a way that captures pertinent clinical facts. Begins to distinguish normal from abnormal findings. Begins to identify relevant negative findings.	Defines problem by identifying pertinent positives and negatives, risk factors, etc. from Initial History (IH). Clearly distinguishes normal from abnormal findings. Omits irrelevant information. Explicitly identifies emergent concerns/possible emergencies.
Comments:
2. Collects and records information about a clinical case in a manner that supports the development of a differential diagnosis (MK).
Does not attempt to collect additional information about case. Additional information is incomplete and is presented with no organization.	Collects data, but not sufficient to explain case. Requests little or no additional information, or gives no rationale for request. Information presented is not well organized.	Usually collects data in an organized manner, but sometimes uses unfocused ‘data grab’ in seeking additional information (‘I would get a complete medical, family, social, and medication history’) or seeks additional information with limited rationale. Organizes most of the case information using a clearly apparent system, such as the SOAP format.	Demonstrates focus and efficiency when collecting data by seeking that additional information that can distinguish among his/her different hypotheses. All case information is well organized (e.g., follows SOAP format) and supports development of a differential diagnosis.
Comments:
3. Develops multiple working hypotheses (i.e., a differential diagnosis) related to clinical diagnosis (MK).
Proposes a single or very few hypotheses.	Does not develop enough hypotheses to progress through the case. Perseverates on hypotheses despite contradictory evidence.	Develops multiple working hypotheses regarding a clinical diagnosis.	Develops multiple working hypotheses regarding a clinical diagnosis in a manner demonstrates an organized approach or structure (e.g ranks or groups hypotheses by likelihood, risk level, etc.).
Comments:
4. Provides a rationale for each hypothesis (IPS).
Provides no rationales for most or all hypotheses.	Provides insufficient rationales for hypotheses. Uses opinion or unsupported hunches (faith-based problem solving: ‘I believe…’).	Usually articulates reasoning by providing a relevant basic science rationale/explanation for each hypothesis. Usually relates key elements of the case to DDX.	Consistently provides a relevant basic science rationale/explanation for each hypothesis. Includes at least an initial assessment of likelihood of each hypothesis for this case based on available case information. Identifies and tolerates low-probability hypotheses with rationale. Includes an explicit statement about how well each hypothesis fits this patient. Identifies case information that doesn’t fit a given hypothesis.
Comments:
5. Provides constructive feedback to peers (IPS).
Provides no feedback to peers.	Provides feedback to peers occasionally. Feedback provided to peers is insufficient or not constructive (e.g., ‘Nice job.’).	Routinely provides constructive feedback to all group members.	Provides constructive feedback for individual group members and offers constructive feedback on the group’s functioning, including strategies for improvement.
Comments:
6. Participates in group problem-solving process (IPS).
Does not contribute to group discussions.	ThinkShare entries address just the basic elements of the case, with limited explanation of thinking. Participates in group discussions occasionally, but not regularly.	ThinkShare entries demonstrate sustained effort to understand most aspects of case. Usually participates in the group problem solving process.	ThinkShare are exemplary: clear, thorough, organized, and thoughtful. Helps to lead the group discussion without dominating.
Comments:
7. Asks relevant questions about the case in order to identify gaps in knowledge necessary to resolve the problem (PLI).
Seldom or never asks relevant questions or identifies gaps in knowledge necessary to resolve the problem.	Occasionally asks relevant questions or identifies gaps in knowledge necessary to resolve the problem. Relies on information from group members or assistance from facilitator in order to formulate questions or identify requisite knowledge.	Usually asks relevant questions about the case. Is able to identify gaps in knowledge necessary to advance the case.	Consistently asks relevant questions about the case. Routinely identifies gaps in knowledge necessary to advance the case. Uses identified gaps in knowledge to organize data collection.
Comments:
8. Identifies and cites appropriate sources of research (PLI).
Does not use or does not cite outside sources of information.	Cites few sources. Uses weak or inappropriate sources. Sometimes does not cite sources.	Cites source(s) used but does not comment on credibility.	Uses and cites appropriate sources and comments on their value.
Comments:
9. Reflects on case and process, including identifying cognitive errors when they arise (PLI).
Provides superficial or dismissive comments in reflections.	Provides brief or otherwise limited comments in reflection (e.g., ‘This case taught me to think more clearly.’). Focuses almost entirely on content of case and content knowledge acquired. Seldom recognizes own or others’ cognitive error (e.g., premature closure).	Comments on what s/he did well or poorly in working on the case. Comments on what aspects of the case made it challenging or easier. Sometimes includes a plan for future improvement. Begins to recognize and address own and others’ cognitive errors.	Describes the approach s/he used in this case, and comments on relative strengths of chosen approach compared with others. Identifies strategies s/he used to make progress/get un-stuck. Outlines specific plan for improving in future cases (not just, ‘Next time I’m going to do better.’). Consistently recognizes and addresses own and others’ cognitive errors.
Comments:
10. Demonstrates awareness or insight into own weaknesses and limitations, and seeks help to address them (PLI).
Demonstrates no awareness of own weaknesses or limitations.	Occasionally demonstrates awareness or insight into own weaknesses and limitations. Only seeks help to address weaknesses when prompted by others.	Regularly demonstrates awareness of own weaknesses and limitations. Sometimes seeks help to address weaknesses/limitations.	Consistently demonstrates awareness of own weaknesses and limitations. Consistently seeks help when needed. Shows dedication to improvement in self and others.
Comments:
11. Acknowledges differences of opinion and perspective among group members (PRO).
Demonstrates belligerence toward or belittles those with different opinions or perspectives.	Acknowledges differences of opinion and perspective among group members, but with some difficulty.	Respectfully acknowledges differences of opinion, perspective, and capabilities among group members.	Models respectful behaviors for others and actively coaches group members.
Comments:
12. Appropriately documents work; research; or contributions to the group process (PRO).
Seldom or never documents work, research, or contributions to the group process.	Occasionally documents work, research, or contributions to the group process.	Regularly documents work, research, or contributions to the group process, although with some lapses or oversights.	Consistently and appropriately documents own and others’ work and contributions, accurately cites research, and recognizes others’ contributions to own work and thinking.
Comments: