From Theory to Practice: Utilizing Competency-Based Milestones to Assess Professional Growth and Development in the Foundational Science Blocks of a Pre-clerkship Medical School Curriculum


Physicians in training require skills and attitudes beyond medical knowledge in order to mature into successful clinicians. However, because assessments in pre-clerkship curricula historically have focused almost exclusively on medical knowledge, faculty contributions to early student development often have been limited. To address this challenge and enhance student progress, we re-designed our pre-clerkship curriculum to include settings in which diverse facets of student performance could be observed and fostered. Concurrently, we transitioned to an assessment strategy focused on competency-based milestones. The implementation of this strategy has allowed pre-clerkship science faculty to provide early-stage students with rich holistic feedback designed to stimulate their professional growth.

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We are grateful to all of our Vanderbilt University School of Medicine colleagues who helped make the transition to competency-based milestone assessment a success. We are especially grateful to Dr. Tyler Reimschisel and Dr. James Atkinson, who together with Dr. Cathleen Pettepher and Dr. Neil Osheroff comprise the leadership team for the pre-clerkship Foundations of Medical Knowledge phase. This publication was prepared with financial support from the American Medical Association (AMA) as part of the Accelerating Change in Medical Education Initiative. The content reflects the views of the authors and does not necessarily represent the views of the AMA or other participants in this initiative. N.O. was supported in part by Grant GM033944 from the National Institutes of Health and Merit Review award I01 Bx002198 from the United States Veterans Administration.

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Correspondence to Cathleen C. Pettepher or Neil Osheroff.

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Pettepher, C.C., Lomis, K.D. & Osheroff, N. From Theory to Practice: Utilizing Competency-Based Milestones to Assess Professional Growth and Development in the Foundational Science Blocks of a Pre-clerkship Medical School Curriculum. Med.Sci.Educ. 26, 491–497 (2016).

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  • Competency-based education
  • Milestones
  • Qualitative assessment
  • Competency domains