APDVS prepares for ACGME Next Accreditation system

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More than 150 program directors and residency coordinators attended the recent spring meeting of the Association for Program Directors in Vascular Surgery (APDVS). The focus of the meeting was an update on the implementation of the Accreditation Council for Graduate Medical Education’s (ACGME) Next Accreditation System (NAS). ACGME is requiring transition to the NAS for vascular surgery by July 2014.

In 2009, ACGME initiated work on a multi-year process of restructuring its accreditation system to better prepare future physicians for practice, with phase in beginning in 2013.

The goal is to accelerate the ACGME’s movement toward accreditation on the basis of educational outcomes and to reduce the burden associated with the current structure and process-based approach.

An important part of the new system will be the use of Milestones to evaluate residents and fellows on a semi-annual basis. ACGME defines Milestones as competency-based developmental outcomes that can be demonstrated progressively by residents and fellows from the beginning of their education through graduation to the unsupervised practice of their specialties. ACGME will use the Milestones to evaluate programs based on the percentage of residents who met the Milestones on time.

Vascular program directors have been looking forward to this move for several years, according to APDVS President Linda Harris, MD, who said it will decrease much of the old system’s unnecessary paperwork.

“The NAS is an exciting move from the ACGME,” Dr. Harris said.

“While the NAS will increase the workload for program directors by adding Milestone assessments, Clinical Competency Committees, and a change in the involvement of program directors in ADS updates, it will allow innovation and a relaxing of restrictions for programs that are functioning well.

“Further, the Milestones will allow us to better assess our trainees and our programs, and eventually, to compare them with other trainees and programs across the country.”

In 2013, the Vascular Surgery Milestones Working Group, chaired by R. James Valentine, MD, drafted Milestones for vascular surgery to define specific targets that residents are expected to attain at certain times during their residency.

In December, APDVS members reviewed a draft of 31 Milestones and provided feedback in preparation of the July rollout. During the spring meeting, held March 28-29 in Rosemont, Illinois, members of the Vascular Surgery Milestones Working Group facilitated breakout groups to further review the Milestones with program directors and residency coordinators. The first reporting of Milestones will begin in December 2014.

To further assist vascular surgery programs with the Milestones, assessment tools are currently being developed. Initial validation results of the Vascular Integrated Technical and Teamwork Assessment for Learning (VITTAL) tool was presented by Erica L. Mitchell, MD, at the spring meeting. The VITTAL tool, which is intended to evaluate vascular surgery trainee operative competency, was developed based on both a systematic review of the literature, as well as expert consensus.

In December, several institutions were selected by the American Board of Surgery-Vascular Surgery Board to serve as pilot sites for multi-institutional validation. Recommendations from the pilot sites were presented to attendees for additional feedback and are currently being analyzed to further enhance the tool.

Additional information on the NAS and the Milestones can be found online at www.acgme.org.

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