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June 02, 2015; 84 (22) Contemporary Issues: Innovations in Education

Milestone-compatible neurology resident assessments

A role for observable practice activities

Lyell K. Jones, Elliot L. Dimberg, Christopher J. Boes, Scott D.Z. Eggers, David W. Dodick, Jeremy K. Cutsforth-Gregory, Andrea N. Leep Hunderfund, David J. Capobianco
First published May 1, 2015, DOI: https://doi.org/10.1212/WNL.0000000000001641
Lyell K. Jones Jr.
From the Department of Neurology (L.K.J., C.J.B., S.D.Z.E., J.K.C.-G., A.N.L.H.), Mayo Clinic, Rochester, MN; the Department of Neurology (E.L.D., D.J.C.), Mayo Clinic, Jacksonville, FL; and the Department of Neurology (D.W.D.), Mayo Clinic, Scottsdale, AZ.
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Elliot L. Dimberg
From the Department of Neurology (L.K.J., C.J.B., S.D.Z.E., J.K.C.-G., A.N.L.H.), Mayo Clinic, Rochester, MN; the Department of Neurology (E.L.D., D.J.C.), Mayo Clinic, Jacksonville, FL; and the Department of Neurology (D.W.D.), Mayo Clinic, Scottsdale, AZ.
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Christopher J. Boes
From the Department of Neurology (L.K.J., C.J.B., S.D.Z.E., J.K.C.-G., A.N.L.H.), Mayo Clinic, Rochester, MN; the Department of Neurology (E.L.D., D.J.C.), Mayo Clinic, Jacksonville, FL; and the Department of Neurology (D.W.D.), Mayo Clinic, Scottsdale, AZ.
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Scott D.Z. Eggers
From the Department of Neurology (L.K.J., C.J.B., S.D.Z.E., J.K.C.-G., A.N.L.H.), Mayo Clinic, Rochester, MN; the Department of Neurology (E.L.D., D.J.C.), Mayo Clinic, Jacksonville, FL; and the Department of Neurology (D.W.D.), Mayo Clinic, Scottsdale, AZ.
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David W. Dodick
From the Department of Neurology (L.K.J., C.J.B., S.D.Z.E., J.K.C.-G., A.N.L.H.), Mayo Clinic, Rochester, MN; the Department of Neurology (E.L.D., D.J.C.), Mayo Clinic, Jacksonville, FL; and the Department of Neurology (D.W.D.), Mayo Clinic, Scottsdale, AZ.
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Jeremy K. Cutsforth-Gregory
From the Department of Neurology (L.K.J., C.J.B., S.D.Z.E., J.K.C.-G., A.N.L.H.), Mayo Clinic, Rochester, MN; the Department of Neurology (E.L.D., D.J.C.), Mayo Clinic, Jacksonville, FL; and the Department of Neurology (D.W.D.), Mayo Clinic, Scottsdale, AZ.
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Andrea N. Leep Hunderfund
From the Department of Neurology (L.K.J., C.J.B., S.D.Z.E., J.K.C.-G., A.N.L.H.), Mayo Clinic, Rochester, MN; the Department of Neurology (E.L.D., D.J.C.), Mayo Clinic, Jacksonville, FL; and the Department of Neurology (D.W.D.), Mayo Clinic, Scottsdale, AZ.
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David J. Capobianco
From the Department of Neurology (L.K.J., C.J.B., S.D.Z.E., J.K.C.-G., A.N.L.H.), Mayo Clinic, Rochester, MN; the Department of Neurology (E.L.D., D.J.C.), Mayo Clinic, Jacksonville, FL; and the Department of Neurology (D.W.D.), Mayo Clinic, Scottsdale, AZ.
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Citation
Milestone-compatible neurology resident assessments
A role for observable practice activities
Lyell K. Jones, Elliot L. Dimberg, Christopher J. Boes, Scott D.Z. Eggers, David W. Dodick, Jeremy K. Cutsforth-Gregory, Andrea N. Leep Hunderfund, David J. Capobianco
Neurology Jun 2015, 84 (22) 2279-2283; DOI: 10.1212/WNL.0000000000001641

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Abstract

Objective: Beginning in 2014, US neurology residency programs were required to report each trainee's educational progression within 29 neurology Milestone competency domains. Trainee assessment systems will need to be adapted to inform these requirements. The primary aims of this study were to validate neurology resident assessment content using observable practice activities (OPAs) and to develop assessment formats easily translated to the Neurology Milestones.

Methods: A modified Delphi technique was used to establish consensus perceptions of importance of 73 neurology OPAs among neurology educators and trainees at 3 neurology residency programs. A content validity score (CVS) was derived for each neurology OPA, with scores ≥4.0 determined in advance to indicate sufficient content validity.

Results: The mean CVS for all OPAs was 4.4 (range 3.5–5.0). Fifty-seven (78%) OPAs had a CVS ≥4.0, leaving 16 (22%) below the pre-established threshold for content validity. Trainees assigned a higher importance to individual OPAs (mean CVS 4.6) compared to faculty (mean 4.4, p = 0.016), but the effect size was small (η2 = 0.10). There was no demonstrated effect of length of education experience on perceived importance of neurology OPAs (p = 0.23). Two sample resident assessment formats were developed, one using neurology OPAs alone and another using a combination of neurology OPAs and the Neurology Milestones.

Conclusions: This study provides neurology training programs with content validity evidence for items to include in resident assessments, and sample assessment formats that directly translate to the Neurology Milestones. Length of education experience has little effect on perceptions of neurology OPA importance.

GLOSSARY

ACGME=
Accreditation Council for Graduate Medical Education;
CVS=
content validity scores;
GME=
graduate medical education;
OPA=
observable practice activity

Footnotes

  • Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.

  • Supplemental data at Neurology.org

  • Editorial, page 2206

  • Received October 16, 2014.
  • Accepted in final form December 29, 2014.
  • © 2015 American Academy of Neurology
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