地域医療と健康教育

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Competencies, Milestones and Observable Activities: Practical Implications for an Undergraduate Medical Education Program

DeWaay DJ, Duckett AA, Friesinger MK, Ledford CH, Walsh KJ

Problem: Although many medical schools describe themselves as being competency based, the use of milestones is still a new concept in undergraduate medical education (UME).

Intervention: In the 2012-2013 academic year the Medical University of South Carolina (MUSC) and The Ohio State University College of Medicine (OSUCOM) independently implemented milestone-based innovations in the internal medicine core clerkships intended to improve teaching and measure student progress across the clerkship. The programs were interested in the feasibility and educational impact of the use of milestones in the clerkship curriculum.

Context: This curricular change was implemented in two third year Internal Medicine clerkship rotations at two large academic tertiary care medical schools.

Outcome: Milestones were successfully integrated into both clerkships as measured by improved or steadily excellent student evaluation of the courses. Student performance on exams or clinical assessments was unchanged.

Lessons learned: A milestone-based system can be successfully integrated into 3rd year Internal Medicine Clerkships. This type of system may be a way to improve clarity of objectives. However, the transition to a milestonebased curriculum requires increased faculty time and a need for direct observation of students.