How to Use Med-Challenger with ACGME Milestones

Kelly SeagravesGroup Education

ACGME Milestones Management System

How to Use Med-Challenger with ACGME Milestones


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The ACGME Milestones for your specialty include, but are not limited to, clinical knowledge expertise built in accordance with the knowledge blueprint for the specialty.

Milestone competencies are rated in Level 1 to 5, with Level 4 being the requirement for successful completion of a residency. For clinical knowledge expectations, Level 1 is the typical entry level expectation from M4 graduates.

Med-Challenger comes into play in providing and tracking a core curriculum study plan, and producing periodic diagnostic examinations.

With Med-Challenger, a score of 85% to 100% on dynamic examinations, or static baseline examinations, covering the entire course are considered to have the clinical knowledge skills required for Level 4 in most milestones.

Mind you, only a portion of each milestone is based on clinical knowledge – we cannot test skills, nor make subjective determinations required of directors or faculty such as “skill in evaluating effectiveness of treatments or therapies.”

However, given our ability to assign content and testing electronically – even create and assign custom exams – Med-Challenger makes it easy for education directors to deploy subject matter testing as digital assignments in support of rotational training and milestone objectives.

Case-based Level 4 Q&A with detailed answers strengthen and enrich milestone-related proficiency.

Learners can achieve milestones faster and education directors can point to successes in assigned self-assessments as proof.

Med-Challenger is designed to work both for rotation-based (milestone-aimed) examinations and broader clinical knowledge examinations required for certification exam preparation.

The topical structure of our courses are laid out the same way the specialty blueprint are laid out, and all specialty blueprints are laid out in a similar systems structure, beginning with presentations, and working forward through each organ system.

In short, our content is already organized in clinical sections and topic sets that address skills crucial in achieving milestones.

Baseline Examinations

A baseline examination is usually built from a static selection of questions, and can be at the topic level, multiple topics, or cover the entire blueprint. For instance, before entering a general cardiovascular rotation the faculty may create a baseline exam covering all the topics in cardiovascular, and test the residents before entering the rotation, and again, with the same questions, on completing the rotation.

This provides the residency management with two important pieces of information. First, what was the measurable improvement in the PGY between the start and finish of the rotation, and second, does the PGY as a whole show any noticeable gaps as a whole.

Baselines can also be used with individual residents when assessing the impact of assignment of remediation material, or identifying broad gaps in clinical knowledge.

With Med-Challenger, a score of 85% to 100% on dynamic examinations, or static baseline exams covering key point throughout an entire course, are considered to have the clinical knowledge skills required for Level 4 in most milestones.
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Dynamic Examinations (Adaptive Exams)

A dynamic examination pulls Q&A randomly from the topics or selected topics chosen for the exam, each time it is taken. This avoids, to a degree, repeating the same questions over and over. Special examinations, such as the Boards Simulator included in the specialty blueprints, are designed to pull from topics in the same percentage order as the actual boards.

But dynamic examinations may also be constructed for specific subtopics or topics within the specialty to provide a clearer picture of learning and improvement than a static exam. In a static exam, when used more than a couple of times, a user may come to anticipate the answers to the questions, while a dynamic exam provides a lot more randomization.

Dynamic exams also provide adaptive learning benefits. Questions that are answered incorrectly by a student will be remembered and subtly re-issued to that student in subsequent uses of that exam. The idea is…adaptive learning ensures students see everything…and it ensures they master everything.

Competency Based Medical Education

The big change in the ACGME’s Next Accreditation System (NAS) is the adoption of competency based medical education. Med-Challenger provides three methods of provable education performance in clinical knowledge:

  • Baseline Examinations for ‘before’ and ‘after’ studies
  • Randomized topic exams and rotation exams
  • Complete randomized blueprint exams to show year over year performance

These are also used with Med-Challenger’s adaptive and prescriptive learning features, where knowledge gaps can be identified in a PGY or individual, and assignable topics for learning recommended by the program.

Assignment of dynamic and static periodic examinations, and the use of the boards simulator in PGY’s provide a stable and long history over the course the residents tenure, as well as improved ITE and certification scores.

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Med-Challenger’s Group Education Platform is designed to specifically address the educational training, testing, and exam outcome objectives of residencies, PA programs, nursing programs, med-schools, and other groups where clinical knowledge quality is a priority.

Med-Challenger offers free program trials here.

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