Blood Banking/Transfusion Medicine Milestones - ACGME

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Blood Banking/Transfusion Medicine Milestones - ACGME
Blood Banking/Transfusion
                                                       Medicine Milestones
                                         The Accreditation Council for Graduate Medical Education

                                                                  Second Revision: November 2020
                                                                      First Revision: May 2014

©2020 Accreditation Council for Graduate Medical Education (ACGME)
All rights reserved except the copyright owners grant third parties the right to use the Blood Banking/Transfusion Milestones on a non-exclusive basis for educational
purposes.
Blood Banking/Transfusion Medicine Milestones

The Milestones are designed only for use in evaluation of fellows in the context of their participation in ACGME-
accredited residency or fellowship programs. The Milestones provide a framework for the assessment of the
development of the fellow in key dimensions of the elements of physician competence in a specialty or
subspecialty. They neither represent the entirety of the dimensions of the six domains of physician competency,
nor are they designed to be relevant in any other context.

©2020 Accreditation Council for Graduate Medical Education (ACGME)
All rights reserved except the copyright owners grant third parties the right to use the Blood Banking/Transfusion Medicine Milestones on a non-exclusive basis for educational
purposes.
                                                                                                                                                                                  i
Blood Banking/Transfusion Medicine Milestones Work Group

                                                                  Carrie Bowler, MS, MLS(CM)
                                                                      Sally Campbell Lee, MD
                                                                          Ronald Domen, MD
                                                                      Laura Edgar, CAE, EdD
                                                                         Melissa George, DO
                                                                             Andrea Ho, MD
                                                                        Sydney McLean, MHA
                                                                           Kerry O’Brien, MD
                                                                             Kinjal Shah, MD
                                                                          James Stubbs, MD
                                                                          Mrigender Virk, MD

The ACGME would like to thank the following organizations for their continued support in the development
of the Milestones:

                                                            American Association of Blood Banks

                                                                  American Board of Pathology

                                                                Review Committee for Pathology

©2020 Accreditation Council for Graduate Medical Education (ACGME)
All rights reserved except the copyright owners grant third parties the right to use the Blood Banking/Transfusion Medicine Milestones on a non-exclusive basis for educational
purposes.
                                                                                                                                                                                  ii
Understanding Milestone Levels and Reporting

This document presents the Milestones, which programs use in a semi-annual review of fellow performance, and then report to the
ACGME. Milestones are knowledge, skills, attitudes, and other attributes for each of the ACGME Competencies organized in a
developmental framework. The narrative descriptions are targets for resident/fellow performance throughout their educational
program.

Milestones are arranged into levels. Tracking from Level 1 to Level 5 is synonymous with moving from novice to expert fellow in the
specialty or subspecialty. For each reporting period, the Clinical Competency Committee will review the completed evaluations to
select the milestone levels that best describe each learner’s current performance, abilities, and attributes for each subcompetency.

These levels do not correspond with post-graduate year of education. Depending on previous experience, a junior fellow may achieve
higher levels early in his/her educational program just as a senior fellow may be at a lower level later in his/her educational program.
There is no predetermined timing for a resident to attain any particular level. Fellows may also regress in achievement of their
milestones. This may happen for many reasons, such as over scoring in a previous review, a disjointed experience in a particular
procedure, or a significant act by the fellow.

Selection of a level implies the fellow substantially demonstrates the milestones in that level, as well as those in lower levels (see the
diagram on page vi).

©2020 Accreditation Council for Graduate Medical Education (ACGME)
All rights reserved except the copyright owners grant third parties the right to use the Blood Banking/Transfusion Medicine Milestones on a non-exclusive basis for educational
purposes.
                                                                                                                                                                                  iii
Additional Notes

Level 4 is designed as a graduation goal but does not represent a graduation requirement. Making decisions about readiness for
graduation and unsupervised practice is the purview of the program director. Furthermore, Milestones 2.0 include revisions and
changes that preclude using Milestones as a sole assessment in high-stakes decisions (i.e., determination of eligibility for certification
or credentialing). Level 5 is designed to represent an expert fellow whose achievements in a subcompetency are greater than the
expectation. Milestones are primarily designed for formative, developmental purposes to support continuous quality improvement for
individual learners, education programs, and the specialty. The ACGME and its partners will continue to evaluate and perform
research on the Milestones to assess their impact and value.

Some milestone descriptions include statements about performing independently. These activities must occur in conformity to
ACGME supervision guidelines as described in the Program Requirements, as well as to institutional and program policies. For
example, a fellow who performs a procedure independently must, at a minimum, be supervised through oversight.

A Supplemental Guide is also available to provide the intent of each subcompetency, examples for each level, assessment methods
or tools, and other available resources. The Supplemental Guide, like examples contained within the Milestones, is designed only to
assist the program director and Clinical Competency Committee, and is not meant to demonstrate any required element or outcome.

Additional resources are available in the Milestones section of the ACGME website. Follow the links under “What We Do” at
www.acgme.org.

©2020 Accreditation Council for Graduate Medical Education (ACGME)
All rights reserved except the copyright owners grant third parties the right to use the Blood Banking/Transfusion Medicine Milestones on a non-exclusive basis for educational
purposes.
                                                                                                                                                                                  iv
The diagram below presents an example set of milestones for one subcompetency in the same format as the ACGME Report
         Worksheet. For each reporting period, a fellow’s performance on the milestones for each subcompetency will be indicated by
         selecting the level of milestones that best describes that fellow’s performance in relation to those milestones.

                           Selecting a response box in the                              Selecting a response box on the line in
                           middle of a level implies that                               between levels indicates that milestones
                           milestones in that level and in lower                        in lower levels have been substantially
                           levels have been substantially                               demonstrated as well as some
                           demonstrated.                                                milestones in the higher level(s).

©2020 Accreditation Council for Graduate Medical Education (ACGME)
All rights reserved except the copyright owners grant third parties the right to use the Blood Banking/Transfusion Medicine Milestones on a non-exclusive basis for educational
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                                                                                                                                                                                  v
Version 2                       Blood Banking/Transfusion Medicine Milestones, ACGME Report Worksheet

 Patient Care 1: Consultation

 Level 1                           Level 2                            Level 3                             Level 4                          Level 5
 Describes the use of a            For simple consultations,          For complex                         Manages complex                  Recognized as an expert
 consultation and lists            delineates the clinical            consultations, delineates           consultations                    in providing
 useful resources                  question, obtains                  the clinical question,              independently with               comprehensive
                                   additional clinical                obtains additional clinical         comprehensive, timely            consultations
                                   information, can access            information, applies                documentation of
                                   available resources,               relevant resources, and             findings and
                                   recommends next steps,             recommends next steps               recommendations
                                   and documents, with                with assistance; manages
                                   assistance                         simple consultations
                                                                      independently

 Comments:
                                                                                                                              Not Yet Completed Level 1
                                                                                                                              Not Yet Rotated

©2020 Accreditation Council for Graduate Medical Education (ACGME)
All rights reserved except the copyright owners grant third parties the right to use the Blood Banking/Transfusion Medicine Milestones on a non-exclusive basis for
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                                                                                                                                                                      1
Version 2                       Blood Banking/Transfusion Medicine Milestones, ACGME Report Worksheet

 Patient Care 2: Therapeutic and Donor Procedures

 Level 1                           Level 2                            Level 3                             Level 4                          Level 5
 Manages uncomplicated             Independently manages              Manages complicated                 Independently manages            Serves as an expert
 apheresis procedures              uncomplicated apheresis            apheresis procedures,               complicated apheresis            resource in apheresis
 (e.g., therapeutic,               procedures                         with assistance                     procedures                       management
 hematopoietic progenitor
 cell collection, donor
 collections) with
 assistance

 Comments:
                                                                                                                             Not Yet Completed Level 1
                                                                                                                             Not Yet Rotated

©2020 Accreditation Council for Graduate Medical Education (ACGME)
All rights reserved except the copyright owners grant third parties the right to use the Blood Banking/Transfusion Medicine Milestones on a non-exclusive basis for
educational purposes.
                                                                                                                                                                      2
Version 2                       Blood Banking/Transfusion Medicine Milestones, ACGME Report Worksheet

 Patient Care 3: Interpretation and Diagnosis

 Level 1                           Level 2                            Level 3                             Level 4                          Level 5
 Develops a differential           Independently develops a           Integrates test results and         Independently                    Serves as a local expert
 diagnosis based on test           differential diagnosis             the clinical scenario to            integrates test results          to inform clinical care
 results, with assistance          based on test results              make recommendations                and the clinical scenario
                                                                      for clinical care, with             to make
                                                                      assistance                          recommendations for
                                                                                                          clinical care

 Comments:
                                                                                                                             Not Yet Completed Level 1
                                                                                                                             Not Yet Rotated

©2020 Accreditation Council for Graduate Medical Education (ACGME)
All rights reserved except the copyright owners grant third parties the right to use the Blood Banking/Transfusion Medicine Milestones on a non-exclusive basis for
educational purposes.
                                                                                                                                                                      3
Version 2                       Blood Banking/Transfusion Medicine Milestones, ACGME Report Worksheet

 Patient Care 4: Reporting

 Level 1                           Level 2                            Level 3                             Level 4                          Level 5
 Identifies the key                Generates timely reports           Generates timely reports            Independently                    Independently generates
 elements of a complete            for simple cases,                  that includes ancillary             generates timely reports         nuanced reports that
 report and demonstrates           including                          testing for complex cases,          that include ancillary           expresses the ambiguity
 understanding of timely           recommendations, with              with assistance;                    testing for complex              and uncertainty of
 reporting                         assistance                         independently generates             cases                            complex cases
                                                                      reports for simple cases

 Comments:
                                                                                                                              Not Yet Completed Level 1
                                                                                                                              Not Yet Rotated

©2020 Accreditation Council for Graduate Medical Education (ACGME)
All rights reserved except the copyright owners grant third parties the right to use the Blood Banking/Transfusion Medicine Milestones on a non-exclusive basis for
educational purposes.
                                                                                                                                                                      4
Version 2                       Blood Banking/Transfusion Medicine Milestones, ACGME Report Worksheet

 Medical Knowledge 1: Immunohematology Testing

 Level 1                           Level 2                            Level 3                             Level 4                          Level 5
 Identifies components of          Distinguishes normal and           Interprets basic and                Independently interprets         Serves as an expert
 basic donor and patient/          abnormal donor and                 complex donor and                   basic and complex                resource in
 recipient                         patient/recipient                  patient/recipient                   donor and                        immunohematology
 immunohematology test             immunohematology test              immunohematology test               patient/recipient
 results                           results                            results, with assistance            immunohematology test
                                                                                                          results

 Describes basic                   Differentiates donor               Recognizes limitations of           Directs additional
 principles and                    versus patient/recipient           immunohematology                    immunohematology
 methodology of                    immunohematology                   testing methodology                 testing as necessary to
 immunohematology tests            testing                                                                resolve complex
                                                                                                          problems

 Comments:
                                                                                                                        Not Yet Completed Level 1
                                                                                                                        Not Yet Rotated

©2020 Accreditation Council for Graduate Medical Education (ACGME)
All rights reserved except the copyright owners grant third parties the right to use the Blood Banking/Transfusion Medicine Milestones on a non-exclusive basis for
educational purposes.
                                                                                                                                                                      5
Version 2                       Blood Banking/Transfusion Medicine Milestones, ACGME Report Worksheet

 Medical Knowledge 2: Donor Management and Component Manufacture

 Level 1                           Level 2                            Level 3                             Level 4                          Level 5
 Describes basic                   Interprets donor infectious        Independently interprets            Directs additional               Serves as an expert
 principles and                    disease test results and           donor infectious disease            infectious disease               resource in interpretation
 methodology of donor              determines donor                   test results, determines            testing as necessary to          of donor infectious
 infectious disease                eligibility, with assistance       donor eligibility, and              resolve donor eligibility        disease testing and donor
 screening and eligibility                                            product disposition                 issues                           eligibility

 Describes basic                   Identifies component               Resolves common                     Independently resolves           Suggests or implements
 principles and                    acceptability criteria and         manufacturing issues,               common and unusual               workflow process
 methodology of                    potential issues in                with assistance                     manufacturing issues             changes to prevent
 component                         manufacturing                                                                                           manufacturing issues
 manufacturing

 Comments:
                                                                                                                        Not Yet Completed Level 1
                                                                                                                        Not Yet Rotated

©2020 Accreditation Council for Graduate Medical Education (ACGME)
All rights reserved except the copyright owners grant third parties the right to use the Blood Banking/Transfusion Medicine Milestones on a non-exclusive basis for
educational purposes.
                                                                                                                                                                        6
Version 2                       Blood Banking/Transfusion Medicine Milestones, ACGME Report Worksheet

Medical Knowledge 3: Apheresis

Level 1                            Level 2                            Level 3                             Level 4                          Level 5
Describes basic                    Uses basic clinical tests          Identifies potential                Integrates advanced              Serves as an expert
principles, methodology,           and physical exam                  complications of                    knowledge of common              resource in therapeutic
and risks of apheresis             findings/vital signs in the        apheresis                           risk factors and                 apheresis
                                   assessment and                                                         complications in
                                   management of apheresis                                                therapeutic apheresis
                                   patients

Identifies resources to            Demonstrates knowledge             Seeks and integrates                Independently seeks
guide apheresis practice           of diseases commonly               evidence-based                      and integrates
                                   treated with apheresis             information to inform               evidence-based
                                                                      application of therapeutic          information to inform
                                                                      apheresis to uncommon               application of
                                                                      cases, with assistance              therapeutic apheresis to
                                                                                                          uncommon cases

Comments:
                                                                                                                        Not Yet Completed Level 1
                                                                                                                        Not Yet Rotated

©2020 Accreditation Council for Graduate Medical Education (ACGME)
All rights reserved except the copyright owners grant third parties the right to use the Blood Banking/Transfusion Medicine Milestones on a non-exclusive basis for
educational purposes.
                                                                                                                                                                      7
Version 2                       Blood Banking/Transfusion Medicine Milestones, ACGME Report Worksheet

 Medical Knowledge 4: Transfusion Practice

 Level 1                           Level 2                            Level 3                             Level 4                          Level 5
 Describes blood                   Identifies blood bank and          Interprets common                   Interprets complex               Serves as an expert
 components and their              supplemental testing               supplemental testing                supplemental testing             resource in transfusion
 generally accepted                (e.g., hematology,                 results and integrates with         results and integrates           practice and sets
 indications                       hemostasis) to guide               blood bank testing results          with blood bank testing          institutional guidelines
                                   transfusion practice,              to guide transfusion                results to guide
                                   including blood product            practice                            transfusion practice
                                   selection

 Comments:
                                                                                                                              Not Yet Completed Level 1
                                                                                                                              Not Yet Rotated

©2020 Accreditation Council for Graduate Medical Education (ACGME)
All rights reserved except the copyright owners grant third parties the right to use the Blood Banking/Transfusion Medicine Milestones on a non-exclusive basis for
educational purposes.
                                                                                                                                                                      8
Version 2                       Blood Banking/Transfusion Medicine Milestones, ACGME Report Worksheet

 Medical Knowledge 5: Cellular Therapy and Transplantation

 Level 1                           Level 2                            Level 3                             Level 4                          Level 5
 Describes different               Distinguishes clinical             Recognizes complications            Integrates knowledge of          Serves as an expert
 collection procedures             scenarios that require             unique to hematopoietic             hematopoietic                    resource in cellular
 and sources of                    different hematopoietic            progenitor cell source              progenitor cell sources,         therapy
 hematopoietic progenitor          progenitor cell sources                                                collection, and
 cells and their clinical                                                                                 monitoring of
 application                                                                                              engraftment into patient
                                                                                                          care

 Describes basic                   Identifies product                 Recommends when                     Applies special
 principles and                    acceptability criteria and         special modifications are           modifications for patient
 methodology of product            special considerations for         needed                              care and assesses
 processing and                    processing,                                                            efficacy of product
 manufacturing                     manufacturing, and
                                   storage

 Identifies the importance         Describes specialized              Integrates specialized test         Independently
 of specialized testing            testing methods relevant           results relevant to                 integrates specialized
 relevant to                       to transplantation                 transplantation, with               test results relevant to
 transplantation (e.g.,                                               assistance                          transplantation
 human leukocyte
 antigen)

 Comments:
                                                                                                                              Not Yet Completed Level 1
                                                                                                                              Not Yet Rotated

©2020 Accreditation Council for Graduate Medical Education (ACGME)
All rights reserved except the copyright owners grant third parties the right to use the Blood Banking/Transfusion Medicine Milestones on a non-exclusive basis for
educational purposes.
                                                                                                                                                                      9
Version 2                       Blood Banking/Transfusion Medicine Milestones, ACGME Report Worksheet

 Medical Knowledge 6: Clinical Reasoning

 Level 1                           Level 2                            Level 3                             Level 4                          Level 5
 Demonstrates a basic              Demonstrates clinical              Synthesizes information             Independently                    Demonstrates intuitive
 framework for clinical            reasoning to determine             to inform clinical                  synthesizes information          approach to clinical
 reasoning                         relevant information               reasoning, with                     to inform clinical               reasoning for complex
                                                                      assistance                          reasoning in complex             cases
                                                                                                          cases

 Identifies appropriate            Selects relevant                   Seeks and integrates                Independently seeks
 resources to inform               resources based on                 evidence-based                      out, analyzes, and
 clinical reasoning                scenario to inform                 information to inform               applies relevant original
                                   decisions                          diagnostic decision                 research to diagnostic
                                                                      making in complex cases,            decision making in
                                                                      with assistance                     complex clinical cases

 Comments:
                                                                                                                        Not Yet Completed Level 1
                                                                                                                        Not Yet Rotated

©2020 Accreditation Council for Graduate Medical Education (ACGME)
All rights reserved except the copyright owners grant third parties the right to use the Blood Banking/Transfusion Medicine Milestones on a non-exclusive basis for
educational purposes.
                                                                                                                                                                      10
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 Systems-Based Practice 1: Patient Safety and Quality Improvement (QI)

 Level 1                           Level 2                            Level 3                             Level 4                          Level 5
 Demonstrates                      Identifies system factors          Participates in analysis of         Conducts analysis of             Actively engages teams
 knowledge of common               that lead to patient safety        patient safety events               patient safety events            and processes to modify
 patient safety events             events                             (simulated or actual)               and offers error                 systems to prevent
                                                                                                          prevention strategies            patient safety events
                                                                                                          (simulated or actual)

 Demonstrates                      Reports patient safety             Participates in disclosure          Discloses patient safety         Role models or mentors
 knowledge of how to               events through                     of patient safety events to         events to clinicians             others in the disclosure of
 report patient safety             institutional reporting            clinicians and/or patients          and/or patients and              patient safety events
 events                            systems (simulated or              and families, as                    families, as appropriate
                                   actual)                            appropriate (simulated or           (simulated or actual)
                                                                      actual)

 Demonstrates                      Describes departmental             Participates in                     Demonstrates the skills          Creates, implements, and
 knowledge of basic QI             and institutional QI               departmental and                    required to identify,            assesses QI initiatives at
 methodologies and                 initiatives                        institutional QI initiatives        develop, implement,              the institutional or
 metrics                                                                                                  and analyze a QI                 community level
                                                                                                          project

 Comments:
                                                                                                                              Not Yet Completed Level 1

©2020 Accreditation Council for Graduate Medical Education (ACGME)
All rights reserved except the copyright owners grant third parties the right to use the Blood Banking/Transfusion Medicine Milestones on a non-exclusive basis for
educational purposes.
                                                                                                                                                                      11
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 Systems-Based Practice 2: Systems Navigation for Patient-Centered Care

 Level 1                           Level 2                            Level 3                             Level 4                          Level 5
 Demonstrates                      Coordinates care of                Coordinates care of                 Models effective                 Analyzes the process of
 knowledge of case                 patients in routine cases          patients in complex cases           coordination of patient-         care coordination and
 coordination                      effectively using                  effectively using                   centered care among              leads in the design and
                                   interprofessional teams            interprofessional teams             different disciplines and        implementation of
                                                                                                          specialties                      improvements

 Identifies key elements           Performs safe and                  Performs safe and                   Models and advocates             Improves quality of
 for safe and effective            effective transitions of           effective transitions of            for safe and effective           transitions of care within
 transitions of care and           care/hand-offs in routine          care/hand-offs in complex           transitions of care/hand-        and across health care
 hand-offs                         situations                         situations                          offs within and across           delivery systems to
                                                                                                          health care delivery             optimize patient outcomes
                                                                                                          systems

 Demonstrates                      Identifies pathology’s role        Identifies opportunities for        Recommends and/or                Leads innovations and
 knowledge of population           in population and                  pathology to participate in         participates in changing         advocates for populations
 and community health              community health needs             community and                       and adapting practice to         and communities with
 needs and disparities             and inequities for the local       population health                   provide for the needs of         health care inequities
                                   population                                                             communities and
                                                                                                          populations

 Comments:
                                                                                                                              Not Yet Completed Level 1

©2020 Accreditation Council for Graduate Medical Education (ACGME)
All rights reserved except the copyright owners grant third parties the right to use the Blood Banking/Transfusion Medicine Milestones on a non-exclusive basis for
educational purposes.
                                                                                                                                                                      12
Version 2                       Blood Banking/Transfusion Medicine Milestones, ACGME Report Worksheet

 Systems-Based Practice 3: Physician Role in Health Care System

 Level 1                           Level 2                            Level 3                             Level 4                          Level 5
 Identifies key                    Describes how                      Discusses how individual            Manages various                  Advocates for or leads
 components of the                 components of a complex            practice affects the                components of the                systems change that
 complex health care               health care system are             broader system (e.g.,               complex health care              enhances high-value,
 system (e.g., inpatient           interrelated, and how this         blood product inventory,            system to provide                efficient, and effective
 /outpatient care, blood           impacts patient care               product/test use,                   efficient and effective          patient care and
 donor center, finance,                                               turnaround time)                    patient care and                 transitions of care
 personnel, technology)                                                                                   transitions of care

 Describes basic health            Documents testing detail           Engages with clinicians             Practices and                    Participates in health
 payment systems (e.g.,            and explains the impact of         and/or patients in shared           advocates for cost               policy advocacy activities
 government, private,              documentation on billing           decision making, such as            effective patient care
 public, uninsured care)           and reimbursement                  use of preauthorization for         with consideration of the
 and practice models                                                  complex testing                     limitations of each
                                                                                                          patient’s payment
                                                                                                          model

 Comments:
                                                                                                                               Not Yet Completed Level 1

©2020 Accreditation Council for Graduate Medical Education (ACGME)
All rights reserved except the copyright owners grant third parties the right to use the Blood Banking/Transfusion Medicine Milestones on a non-exclusive basis for
educational purposes.
                                                                                                                                                                        13
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 Systems-Based Practice 4: Accreditation, Compliance, and Quality

 Level 1                           Level 2                            Level 3                             Level 4                          Level 5
 Demonstrates                      Demonstrates knowledge             Identifies the differences          Participates in an               Serves as a resource for
 knowledge that                    of the components of               between accreditation               internal or external             accreditation at the
 laboratories must be              laboratory accreditation           and regulatory                      laboratory inspection            regional or national level
 accredited                        and regulatory                     compliance; discusses
                                   compliance (e.g., Food             the process for achieving
                                   and Drug Administration,           accreditation and
                                   AABB, Foundation for the           maintaining regulatory
                                   Accreditation of Cellular          compliance
                                   Therapy [FACT], College
                                   of American Pathology,
                                   Clinical Laboratory
                                   Improvement
                                   Amendments), either
                                   through training or
                                   experience

 Discusses the need for            Interprets quality data and        Demonstrates knowledge              Reviews the quality              Creates and follows a
 quality control and               charts and trends,                 of the components of a              management plan to               comprehensive quality
 proficiency testing               including proficiency              laboratory quality                  identify areas for               management plan
                                   testing results, with              management plan                     improvement
                                   assistance

                                                                      Discusses implications of           Analyzes proficiency             Independently formulates
                                                                      proficiency testing failures        testing failures and             a response for proficiency
                                                                                                          recommends a course              testing failures
                                                                                                          of action, with oversight

 Comments:
                                                                                                                              Not Yet Completed Level 1

©2020 Accreditation Council for Graduate Medical Education (ACGME)
All rights reserved except the copyright owners grant third parties the right to use the Blood Banking/Transfusion Medicine Milestones on a non-exclusive basis for
educational purposes.
                                                                                                                                                                        14
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 Systems-Based Practice 5: Utilization

 Level 1                           Level 2                            Level 3                             Level 4                          Level 5
 Identifies general                Explains rationale for             Identifies opportunities to         Initiates efforts to             Completes a utilization
 pathology work practices          optimizing utilization             optimize utilization of             optimize utilization             review and implements
 and workflow (e.g., blood                                            pathology resources                                                  change
 product issuing,
 immunohematologic
 testing)

 Comments:
                                                                                                                              Not Yet Completed Level 1
                                                                                                                              Not Yet Rotated

©2020 Accreditation Council for Graduate Medical Education (ACGME)
All rights reserved except the copyright owners grant third parties the right to use the Blood Banking/Transfusion Medicine Milestones on a non-exclusive basis for
educational purposes.
                                                                                                                                                                      15
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 Practice-Based Learning and Improvement 1: Evidence-Based Practice and Scholarship

 Level 1                           Level 2                            Level 3                             Level 4                          Level 5
 Demonstrates how to               Identifies and applies the         Identifies and applies the          Critically appraises and         Teaches others to
 access and select                 best available evidence to         best available evidence to          applies evidence to              critically appraise and
 applicable evidence               guide diagnostic work-up           guide diagnostic work-up            guide care, even in the          apply evidence for
                                   of simple cases                    of complex cases                    face of conflicting data         complex cases; and/or
                                                                                                                                           participates in the
                                                                                                                                           development of guidelines

 Is aware of the need for          Develops knowledge of              Applies knowledge of the            Proactively and                  Suggests improvements
 patient privacy,                  the basic principles of            basic principles of                 consistently applies             to research regulations
 autonomy, and consent             research (e.g.,                    research such as                    knowledge of the basic           and/or substantially
 as applied to clinical            demographics,                      informed consent and                principles of research           contributes to the primary
 research                          Institutional Review               research protocols to               such as informed                 literature through basic,
                                   Board, human subjects),            clinical practice, with             consent and research             translational, or clinical
                                   including how research is          supervision                         protocols to clinical            research
                                   evaluated, explained to                                                practice
                                   patients, and applied to
                                   patient care

 Comments:
                                                                                                                              Not Yet Completed Level 1

©2020 Accreditation Council for Graduate Medical Education (ACGME)
All rights reserved except the copyright owners grant third parties the right to use the Blood Banking/Transfusion Medicine Milestones on a non-exclusive basis for
educational purposes.
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 Practice-Based Learning and Improvement 2: Reflective Practice and Commitment to Personal Growth

 Level 1                           Level 2                            Level 3                             Level 4                          Level 5
 Accepts responsibility for        Demonstrates openness              Seeks performance data              Actively and                     Models seeking
 personal and                      to receiving performance           and feedback with                   consistently seeks               performance data and
 professional                      data and feedback in               humility                            performance data and             accepting feedback with
 development by                    order to inform goals                                                  feedback with humility           humility
 establishing goals

 Identifies the gap(s)             Analyzes and reflects on           Institutes behavioral               Critically evaluates the         Coaches others reflective
 between expectations              the factors which                  change(s) to narrow the             effectiveness of                 practice
 and actual performance            contribute to gap(s)               gap(s) between                      behavioral changes in
                                   between expectations and           expectations and actual             narrowing the gap(s)
                                   actual performance                 performance                         between expectations
                                                                                                          and actual performance

 Actively seeks                    Designs and implements             Independently creates               Uses performance data            Facilitates the design and
 opportunities to improve          a learning plan, with              and implements a                    to measure the                   implementing learning
                                   assistance                         learning plan                       effectiveness of the             plans for others
                                                                                                          learning plan and
                                                                                                          improves it when
                                                                                                          necessary

 Comments:
                                                                                                                              Not Yet Completed Level 1

©2020 Accreditation Council for Graduate Medical Education (ACGME)
All rights reserved except the copyright owners grant third parties the right to use the Blood Banking/Transfusion Medicine Milestones on a non-exclusive basis for
educational purposes.
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 Professionalism 1: Professional Behavior and Ethical Principles

 Level 1                           Level 2                            Level 3                             Level 4                          Level 5
 Demonstrates                      Analyzes straightforward           Recognizes the need and             Independently resolves           Identifies and seeks to
 knowledge of the ethical          situations using ethical           uses appropriate                    and manages complex              address system-level
 principles underlying             principles                         resources to seek help in           ethical situations               factors that induce or
 informed consent,                                                    managing and resolving                                               exacerbate ethical
 surrogate decision                                                   complex ethical situations                                           problems or impede their
 making, advance                                                                                                                           resolution
 directives, confidentiality,
 error disclosure,
 stewardship of limited
 resources, and related
 topics

 Describes when and how            Demonstrates insight into          Demonstrates                        Recognizes situations            Coaches others when
 to appropriately report           professional behavior in           professional behavior in            that may trigger                 their behavior fails to
 professionalism lapses,           routine situations; takes          complex or stressful                professionalism lapses           meet professional
 including strategies for          responsibility for one’s           situations                          and intervenes to                expectations
 addressing common                 own professionalism                                                    prevent lapses in self
 barriers; identifies and          lapses                                                                 and others
 describes potential
 triggers for
 professionalism lapses

 Comments:
                                                                                                                             Not Yet Completed Level 1

©2020 Accreditation Council for Graduate Medical Education (ACGME)
All rights reserved except the copyright owners grant third parties the right to use the Blood Banking/Transfusion Medicine Milestones on a non-exclusive basis for
educational purposes.
                                                                                                                                                                      18
Version 2                       Blood Banking/Transfusion Medicine Milestones, ACGME Report Worksheet

 Professionalism 2: Accountability and Conscientiousness

 Level 1                           Level 2                            Level 3                             Level 4                          Level 5
 Responds promptly to              Takes appropriate                  Recognizes situations               Anticipates and                  Takes ownership of
 instructions, requests, or        ownership and performs             that may impact own                 intervenes in situations         system outcomes
 reminders to complete             tasks and responsibilities         ability to complete tasks           that may impact others’
 tasks and responsibilities        in a timely manner with            and responsibilities in a           ability to complete tasks
                                   attention to detail                timely manner and                   and responsibilities in a
                                                                      describes the impact on             timely manner
                                                                      team
                                                                                                                                           Designs new strategies to
                                                                                                                                           ensure that the needs of
                                                                                                                                           patients, teams, and
                                                                                                                                           systems are met

 Comments:
                                                                                                                              Not Yet Completed Level 1

©2020 Accreditation Council for Graduate Medical Education (ACGME)
All rights reserved except the copyright owners grant third parties the right to use the Blood Banking/Transfusion Medicine Milestones on a non-exclusive basis for
educational purposes.
                                                                                                                                                                      19
Version 2                       Blood Banking/Transfusion Medicine Milestones, ACGME Report Worksheet

 Professionalism 3: Self-Awareness and Help-Seeking

 Level 1                           Level 2                            Level 3                             Level 4                          Level 5
 Recognizes limitations in         Independently recognizes           Proposes and implements             Independently develops           Serves as a resource or
 the knowledge/skills/             limitations in the                 a plan to remediate or              and implements a plan            consultant for developing
 behaviors of self or              knowledge/skills/                  improve the knowledge/              to remediate or improve          a plan to remediate or
 team, with assistance             behaviors of self or team          skills/behaviors of self or         the knowledge/skills/            improve the knowledge/
                                   and seeks help when                team, with assistance               behaviors of self or             skills/behaviors
                                   needed                                                                 team

 Recognizes status of              Independently recognizes           Proposes and implements             Independently develops           Coaches others when
 personal and                      status of personal and             a plan to optimize                  and implements a plan            responses or limitations in
 professional well-being,          professional well-being            personal and professional           to optimize personal             knowledge/skills do not
 with assistance                   and seeks help when                well-being, with                    and professional well-           meet professional
                                   needed                             assistance                          being                            expectations

 Comments:
                                                                                                                              Not Yet Completed Level 1

©2020 Accreditation Council for Graduate Medical Education (ACGME)
All rights reserved except the copyright owners grant third parties the right to use the Blood Banking/Transfusion Medicine Milestones on a non-exclusive basis for
educational purposes.
                                                                                                                                                                       20
Version 2                       Blood Banking/Transfusion Medicine Milestones, ACGME Report Worksheet

 Interpersonal and Communication Skills 1: Patient- and Family-Centered Communication

 Level 1                           Level 2                            Level 3                             Level 4                          Level 5
 Uses language and                 Establishes a relationship         Sensitively and                     Independently,                   Mentors others in the
 nonverbal behavior to             in straightforward                 compassionately delivers            sensitively, and                 sensitive and
 demonstrate respect and           encounters using active            medical information, with           compassionately                  compassionate delivery of
 establish rapport                 listening and clear                assistance                          delivers medical                 medical information
                                   language                                                               information and
                                                                                                          acknowledges
                                                                                                          uncertainty and conflict

 Identifies common                 Identifies complex                 When prompted, reflects             Independently                    Models self-awareness
 barriers to effective             barriers to effective              on personal biases while            recognizes personal              while teaching a
 communication (e.g.,              communication (e.g.,               attempting to minimize              biases while attempting          contextual approach to
 language, disability)             health literacy, cultural)         communication barriers              to proactively minimize          minimize communication
 while accurately                                                                                         communication barriers           barriers
 communicating own role
 within the health care
 system

 Comments:
                                                                                                                              Not Yet Completed Level 1

©2020 Accreditation Council for Graduate Medical Education (ACGME)
All rights reserved except the copyright owners grant third parties the right to use the Blood Banking/Transfusion Medicine Milestones on a non-exclusive basis for
educational purposes.
                                                                                                                                                                      21
Version 2                       Blood Banking/Transfusion Medicine Milestones, ACGME Report Worksheet

 Interpersonal and Communication Skills 2: Interprofessional and Team Communication

 Level 1                           Level 2                            Level 3                             Level 4                          Level 5
 Uses language that                Communicates                       Uses active listening to            Coordinates                      Models flexible
 values all members of             information effectively            adapt communication                 recommendations from             communication strategies
 the health care team              with all health care team          style to fit team needs             different members of             that value input from all
                                   members                                                                the health care team to          health care team
                                                                                                          optimize patient care            members, resolving
                                                                                                                                           conflict when needed

 Describes the utility of          Solicits feedback on               Integrates feedback from            Communicates                     Facilitates regular health
 constructive feedback             performance as a                   team members to improve             feedback and                     care team-based
                                   member of the health               communication                       constructive criticism to        feedback in complex
                                   care team                                                              superiors                        situations

 Comments:
                                                                                                                              Not Yet Completed Level 1

©2020 Accreditation Council for Graduate Medical Education (ACGME)
All rights reserved except the copyright owners grant third parties the right to use the Blood Banking/Transfusion Medicine Milestones on a non-exclusive basis for
educational purposes.
                                                                                                                                                                        22
Version 2                       Blood Banking/Transfusion Medicine Milestones, ACGME Report Worksheet

 Interpersonal and Communication Skills 3: Communication within Health Care Systems

 Level 1                           Level 2                            Level 3                             Level 4                          Level 5
 Safeguards patient                Appropriately selects              Communicates while                  Independently                    Guides departmental or
 personal health                   forms of communication             ensuring security of                communicates while               institutional
 information by                    based on context and               personal health                     ensuring security of             communication around
 communicating through             urgency of the situation           information, with guidance          personal health                  policies and procedures
 appropriate means as                                                                                     information                      regarding the security of
 required by institutional                                                                                                                 personal health
 policy (e.g., patient                                                                                                                     information
 safety reports, cell
 phone/pager usage)

 Identifies institutional          Respectfully                       Uses institutional                  Initiates conversations          Facilitates dialogue
 and departmental                  communicates concerns              structure to effectively            on difficult subjects with       regarding systems issues
 structure for                     about the system                   communicate clear and               appropriate                      among larger community
 communication of issues                                              constructive suggestions            stakeholders to improve          stakeholders (e.g.,
                                                                      to improve the system               the system                       institution, health care
                                                                                                                                           system, field)

 Comments:
                                                                                                                             Not Yet Completed Level 1

©2020 Accreditation Council for Graduate Medical Education (ACGME)
All rights reserved except the copyright owners grant third parties the right to use the Blood Banking/Transfusion Medicine Milestones on a non-exclusive basis for
educational purposes.
                                                                                                                                                                       23
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