Competencies, Milestones, and Entrustable Professional Activities

Abstract

As I sat with my faculty colleagues in a conference room reviewing the files of residents for our residency program’s clinical competency committee, I couldn’t help reflecting upon other ways to rate performance, such as those used in competitive sports. In some cases, like track and field competitions, the rating process is easy; if there is a race, the fastest runner wins and is judged to be the best. Also, a stopwatch provides comparison with other runners across the country. In baseball, there are numerous statistics about batting averages and home runs that can be used to rate and sort the quality of hitting. Even one extra hit every 10 games can make the difference between a good player and an all-star. Sometimes, assessments are more nuanced and require the judgments of experts as well as agreed-upon standards for the experts, to use. For example, ice skaters and gymnasts at the Olympics are scored by experts, based on the performance of various difficult turns, jumps, and landings. As an observer I can recognize the falls but need the observations and judgments of experts to determine the scores. There are even dog shows that rate dogs according to how close they came to an ideal set of characteristics for the breed. ............................... .................... ..............