Milestones in Plastic Surgery: Attending Assessment versus Resident Assessment

Background: The Plastic Surgery Milestones Project was jointly conceived by the ACGME and American Board of Plastic Surgery as a tool to improve granularity in resident feedback. Resident self-evaluations were compared to attending clinical competency committee evaluations to gauge resident self-perceptions and understanding of the milestones framework. Methods: Semi-annual evaluations from June 2014-2017 were analyzed and compared with corresponding resident self-evaluations from the 2015-2017 academic year at the University of Pittsburgh Medical Center. Evaluations were analyzed for overall trends in performance. The Wilcoxon Rank-Sign test was used to identify any systematic differences between evaluations. Subgroup analysis using the chi-square test was performed to determine factors that may contribute to major assessment disparity (≥1). Results: 6,207 milestones across 187 faculty evaluations and 3,139 milestones across 106 resident self-evaluations were available for review. With the exception of PGY-2 residents, residents rated themselves at a significantly lower level in the competencies of medical education and patient care. Post-graduate year, academic year timing, and ACGME competency were associated with major assessment discrepancies. Conclusions: Overall, resident and faculty evaluations at our program were concordant which demonstrates that residents are capable of accurately assessing their own abilities and understanding the milestones framework. Areas of discordance between resident and faculty evaluations fostered discussion between residents and faculty and have led to multiple changes in our program. The introduction of self-evaluation tools at other programs may provide them with similar benefits. Conflict of Interest and Source of Funding: None of the authors has a financial interest in any of the products, devices, or drugs mentioned in this manuscript. Financial Disclosures: No authors have any relevant financial relationships to disclose. Corresponding Author: Ian Chow, MD, Resident Physician, UPMC Department of Plastic Surgery, 3550 Terrace Street, 675 Scaife Hall, Pittsburgh, Pennsylvania 15261, Email: chowi@upmc.edu ©2018American Society of Plastic Surgeons

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