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From Sascha Cohen:

Regarding milestones noted as expectations of achievement level in the curriculum, the way we approach this:

you can see our generic milestones here: http://meded.ucsf.edu/sites/meded.ucsf.edu/files/documents/medical-student-education/md-competencies.pdf

If you take the first listed competency, (History Taking) we would address each milestone by year, and run a simple report identifying each teaching session associated with that competency in the curriculum, and sort / group them according to year. Then, correlate the specific teaching objectives for a session with the identified milestone expectation for it's specific level -- so Major Organ Systems - Heart Failure, taught in winter of 1st year, has a number of objectives including "Describe typical findings on chest x-ray in patients with acute decompensated left ventricular failure." This in turn is associated with the larger course objective of "Based on patient vignettes, select, justify, and interpret diagnostic clinical tests and imaging relevant to diagnosis of cardiac, pulmonary, and renal diseases." These both in turn lead to correlation with the 1st year milestone expectation of: "Begin to apply clinical reasoning to determine relevant information to gather in the history."

Now: does this mean the student actually achieves a particular level of knowledge or competence? No. Does it suggest that there is an evaluative component to this expectation? No. It only shows that in conjunction with the curricular information, there is an expectation of a certain level and depth of understanding and application of that understanding to the material, which can be inferred by the overall curricular map, and the depth or grading of that expectation can be inferred as the longitudinal progress of the curriculum is expressed in more specific or demanding objectives.

Some of our milestones relate directly and explicitly to program level objectives; many others do not. For this reason, the correlation between them and the curriculum tends to be inferential, rather than explicit. But I don't think this devalues the ability to interpret the milestones through their competency object associations with particular content within the curriculum.

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