TABLE 2.
Number of fellows who fell below a level 4 milestone score at the time of graduation
| SC | Descriptor | N (%), Total, N = 392 |
|---|---|---|
| PC1 | Gather essential and accurate information about the patient: abstracts current findings in a patient with multiple chronic medical problems and, when appropriate, compares with a prior medical record and identifies significant differences between the current presentation and past presentations | 32 (8%) |
| PC2 | Organize and prioritize responsibilities to provide patient care that is safe, effective, and efficient | 70 (18%) |
| PC3 | Provide transfer of care that ensures seamless transitions | 40 (10%) |
| PC4 | Make informed diagnostic and therapeutic decisions that result in optimal clinical judgment | 74 (19%) |
| PC5 | Emergency stabilization: prioritizes critical initial stabilization action and mobilizes hospital support services in the resuscitation of a critically ill or injured patient and reassesses after stabilizing intervention | 59 (15%) |
| PC6 | Diagnostic studies: applies the results of diagnostic testing based on the probability of disease and the likelihood of test results altering management | 48 (12%) |
| PC7 | Observation and reassessment: reevaluates patients undergoing ED observation (and monitoring) and, using appropriate data and resources, determines the differential diagnosis, treatment plan, and disposition | 56 (14%) |
| PC8 | Disposition: establishes and implements a comprehensive disposition plan that uses appropriate consultation resources, provides patient education regarding diagnosis, treatment plan, medications, and time‐ and location‐specific disposition instructions | 34 (9%) |
| PC9 | General approach to procedures: performs the indicated procedure on all appropriate patients (including those who are uncooperative, at the extremes of age, or hemodynamically unstable, and those who have multiple comorbidities, poorly defined anatomy, high risk for pain or procedural complications, or sedation requirements), takes steps to avoid potential complications, and recognizes the outcome and/or complications resulting from the procedure | 44 (11%) |
| PC10 | Anesthesia and acute pain management: provides safe acute pain management, anesthesia, and procedural sedation to patients of all ages regardless of the clinical situation | 28 (7%) |
| PC11 | Provide appropriate supervision (milestones for the supervisor) | 47 (12%) |
| MK1 | Demonstrate sufficient knowledge of the basic and clinically supportive sciences appropriate to PEM | 27 (7%) |
| SBP1 | Advocate for quality patient care and optimal patient care systems | 152 (39%) |
| SBP2 | Participate in identifying system errors and implementing potential systems solutions | 140 (36%) |
| PBL1 | Use information technology to optimize learning and care delivery | 118 (30%) |
| PROF1 | Self‐awareness of one's own knowledge, skill, and emotional limitations that leads to appropriate help‐seeking behaviors | 54 (14%) |
| PROF2 | The capacity to accept that ambiguity is part of clinical medicine and to recognize the need for and to utilize appropriate resources in dealing with uncertainty | 78 (20%) |
| PROF3 | Practice flexibility and maturity in adjusting to change with the capacity to alter behavior | 124 (32%) |
| PROF4 | Provide leadership skills that enhance team functioning, the learning environment, and/or the health care delivery system/environment with the ultimate intent of improving care of patients | 58 (15%) |
| PROF5 | Demonstrate self‐confidence that puts patients, families, and members of the health care team at ease | 55 (14%) |
| ICS1 | Communicate effectively with patients, families, and the public, as appropriate, across a broad range of socioeconomic and cultural backgrounds | 47 (12%) |
| ICS2 | Demonstrate the insight and understanding into emotion and human response to emotion that allows one to appropriately develop and manage human interactions | 73 (19%) |
| ICS3 | Act in a consultative role to other physicians and health professionals | 100 (26%) |
Abbreviations: ICS, interpersonal and communication skills; MK, medical knowledge; PBLI, practice‐based learning and improvement; PC, patient care; PEM, pediatric emergency medicine; PROF, professionalism; SBP, systems‐based practice.