Brain Injury Medicine Milestones - ACGME
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Brain Injury Medicine Milestones
The Accreditation Council for Graduate Medical Education
Implementation Date: July 1, 2021
Second Revision: May 2021
First Revision: July 2014
©2021 Accreditation Council for Graduate Medical Education (ACGME)
All rights reserved except the copyright owners grant third parties the right to use the Brain Injury Medicine Milestones on a non-exclusive basis for educational purposes.Brain Injury 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.
©2021 Accreditation Council for Graduate Medical Education (ACGME)
All rights reserved except the copyright owners grant third parties the right to use the Brain Injury Medicine Milestones on a non-exclusive basis for educational purposes.
iiBrain Injury Medicine Milestones Work Group
James Begley, MD Jodi Hawes, MD
Daniel M. Clinchot, MD Cherry Junn, MD
Kelly M. Crawford, MD Sydney McLean, MHA
Laura Edgar, EdD, CAE Bianca Melendez
Charles Flippen II, MD Rosanna Sabini, DO
Gerard Francisco, MD Charles Taylor, MD
Brian Greenwald, MD Jean Woo, MD
The ACGME would like to thank the following organizations for their continued support in the
development of the Milestones:
American Board of Physical Medicine and Rehabilitation
American Board of Psychiatry and Neurology
Review Committee for Neurology
Review Committee for Physical Medicine and Rehabilitation
©2021 Accreditation Council for Graduate Medical Education (ACGME)
All rights reserved except the copyright owners grant third parties the right to use the Brain Injury Medicine Milestones on a non-exclusive basis for educational purposes.
iiiUnderstanding 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 iv).
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iiAdditional 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.
©2021 Accreditation Council for Graduate Medical Education (ACGME)
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iiiThe 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).
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ivVersion 2 Brain Injury Medicine, ACGME Report Worksheet
Patient Care 1: History
Level 1 Level 2 Level 3 Level 4 Level 5
Acquires a basic Uses knowledge of Acquires a history, in Efficiently acquires a Mentors others in
history, including brain injury medicine to patients with complex relevant history, gathering subtle,
medical, functional, and acquire a history to conditions and gathering subtle, sensitive, and/or not
psychosocial elements guide the performance comorbidities, including sensitive, and/or not readily volunteered
of the physical psychiatric readily volunteered information
examination information, across a
spectrum of ages,
impairments, and
clinical settings
Comments:
Not Yet Completed Level 1
Not Yet Assessable
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1Version 2 Brain Injury Medicine, ACGME Report Worksheet
Patient Care 2: Physical Examination
Level 1 Level 2 Level 3 Level 4 Level 5
Performs a basic Interprets the Modifies exam to Identifies and correctly Mentors others in
physical and neurologic neurologic exam to accommodate the interprets subtle or physical and neurologic
exam that identifies accurately assess brain patient’s impairments, atypical physical and exam skills in complex
impairments and injury and its sequelae, optimize assessment, neurologic findings from brain injury patients
functional abilities and other non- minimize discomfort, the brain injury
neurologic and preserve patient
comorbidities dignity
Comments:
Not Yet Completed Level 1
Not Yet Assessable
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2Version 2 Brain Injury Medicine, ACGME Report Worksheet
Patient Care 3: Spasticity Management
Level 1 Level 2 Level 3 Level 4 Level 5
Demonstrates basic Provides rationale for Individualizes treatment Adapts a treatment Educates others on
understanding of treatment options choices regarding program for continued spasticity management
spasticity management including oral and medication options spasticity management (procedural and non-
options injectable medications, (e.g., baclofen pump, which modifies for procedural
and non-pharmacologic botulinum toxin better neuromuscular interventions)
treatments (e.g., injection, phenol), control or corrects
physical or occupational dosing, and injection possible side effects
therapy, casting, guidance methods
dynamic splinting,
surgery)
Identifies indications Performs some Performs all Performs all Instructs others on the
and contraindications components of the components of the components of the performance of the
for the procedure procedure, with procedure, including procedure, including procedure a across a
supervision obtaining informed obtaining informed spectrum of
consent, with consent across a presentations
supervision spectrum of
presentations
Diagnoses patients with Assesses the severity Assesses outcomes of Assesses outcomes of Educates others on the
upper motor neuron of spasticity (physically spasticity interventions, spasticity interventions assessment of
hyperactivity syndromes and functionally) and patient’s tolerability, and and manages outcomes across a
by history and physical documents the side effects complications spectrum of treatment
examination assessment accurately choices
before and after
interventions
Comments:
Not Yet Completed Level 1
Not Yet Assessable
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3Version 2 Brain Injury Medicine, ACGME Report Worksheet
Patient Care 4: Evaluation and Diagnosis of Individuals with Brain Injury across the Spectrum of Severity
Level 1 Level 2 Level 3 Level 4 Level 5
Generates a differential Generates a differential Generates a Synthesizes clinical From a comprehensive
diagnosis for common diagnosis that considers comprehensive information and results differential diagnosis
presentations from atypical presentations differential diagnosis, of diagnostic studies in produces a focused and
concussion through across levels of severity including less common the development of a prioritized differential
disorders of and conditions conditions comprehensive diagnosis accounting for
consciousness commonly seen in brain differential diagnosis rare conditions
injury
Orders diagnostic Orders diagnostic Prioritizes the Orders diagnostic Streamlines diagnostic
studies for common studies for conditions sequence and urgency testing based on cost- evaluation for maximal
presentations commonly seen in brain of diagnostic testing effectiveness and cost-effectiveness and
injury likelihood that results minimal patient burden
will influence clinical
management
Interprets basic Interprets more complex Interprets diagnostic Incorporates diagnostic Distinguishes key
diagnostic study results diagnostic study results study results and study results and components of
pursues further testing specialist input into a diagnostic study results
or specialist input care plan and specialists input into
a care plan
Comments:
Not Yet Completed Level 1
Not Yet Assessable
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4Version 2 Brain Injury Medicine, ACGME Report Worksheet
Patient Care 5: Medical/Neuropsychiatric Management of Individuals with Brain Injury across the Spectrum of Severity
Level 1 Level 2 Level 3 Level 4 Level 5
Identifies presence of Identifies level of Identifies individual risk Develops and Educates others on
medical comorbidities medical acuity and factors for secondary implements a development and
directly and indirectly initiates appropriate conditions and potential comprehensive implementation of
related to brain injury treatment complications and treatment plan that comprehensive plans
institutes preventive identifies and that address
care addresses all pertinent comorbidities,
comorbidities, secondary conditions,
secondary conditions, and complications, and
and potential critically evaluates
complications emerging treatments for
efficacy and scientific
validity
Identifies common Performs initial Initiates appropriate Develops and Educates others on
neuropsychiatric diagnostic evaluation of pharmacologic and implements a development and
consequences of brain neuropsychiatric non-pharmacologic comprehensive implementation of a
injury symptoms treatment of individualized treatment comprehensive
neuropsychiatric plan that addresses individualized plans that
symptoms neuropsychiatric address
symptoms neuropsychiatric
symptoms
Comments:
Not Yet Completed Level 1
Not Yet Assessable
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5Version 2 Brain Injury Medicine, ACGME Report Worksheet
Patient Care 6: Therapy and Durable Medical Equipment Management of Individuals with Brain Injury
Level 1 Level 2 Level 3 Level 4 Level 5
Identifies rehabilitation Prescribes rehabilitation Provides therapy Provides detailed Collaborates with
therapies by discipline, therapies by discipline, prescriptions with therapy prescription orthotists, therapists,
based on functional based on functional appropriate precautions for specific conditions and other health care
need need in accordance with in accordance with while adjusting for professionals for
short-term goals short- and long-term short- and long-term problem solving unusual
goals goals clinical and functional
challenges with
therapies
Identifies basic Recognizes the Prescribes commonly Prescribes assistive Serves as an expert
orthoses, mobility aids, indications for basic used orthoses, mobility technologies and resource to other
and assistive orthoses, mobility aids, aids, and assisted mobility devices in stakeholders (e.g.,
technology and assistive technology technology with partnership with the insurance companies)
understanding of interprofessional team for the appropriateness
outcomes of durable medical
equipment and assistive
technologies
Comments:
Not Yet Completed Level 1
Not Yet Assessable
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6Version 2 Brain Injury Medicine, ACGME Report Worksheet
Medical Knowledge 1: Traumatic and Non-Traumatic Brain Injury
Level 1 Level 2 Level 3 Level 4 Level 5
Describes common Demonstrates Demonstrates Role models in Serves as an expert
etiologies of brain knowledge of the knowledge of unique providing education to resource to health care
injuries and risk factors spectrum of severity clinical features in patients, professionals regarding
and prognosis of brain special brain injury families/caregivers, and brain injury
injury populations (e.g., local community about
geriatric, military, brain injury
penetrating)
Describes basic brain Demonstrates the Demonstrates the Demonstrates the Delineates a brain injury-
anatomy, knowledge of effects of knowledge required to knowledge required to specific health
pathophysiology of insult to specific brain diagnose and treat diagnose and treat maintenance and
brain injuries, and regions and makes neurological neurological management program
neurorecovery clinical correlations disorders/impairments disorders/impairments across the lifespan
mechanisms after brain injuries in medically complex
cases
Describes common Demonstrates Describes diagnostic Demonstrates the Describes
complications of brain knowledge of risk and therapeutic knowledge required to interdisciplinary
injuries factors for specific measures for select appropriate approach to treat the
secondary secondary treatment options conditions and
complications and complications based on potential side demonstrates knowledge
appropriate effects and of complementary and
preventative measures contraindications alternative therapies
Comments:
Not Yet Completed Level 1
Not Yet Assessable
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7Version 2 Brain Injury Medicine, ACGME Report Worksheet
Medical Knowledge 2: Functional Outcomes and Assessment across the Entire Spectrum of Brain Injury Severity
Level 1 Level 2 Level 3 Level 4 Level 5
Demonstrates basic Demonstrates advanced Integrates a generalized Integrates a Provides comprehensive
knowledge in the knowledge in the assessment based on comprehensive recommendations
assessment of assessment of an individual’s injury to assessment of an related to functional
functional impairments functional impairments determine functional individual to include outcomes based on
outcomes broader aspects of the ongoing assessments
injury to determine
functional outcomes
Determines basic Determines advanced Synthesizes prognosis Integrates assessment Delivers evidence-based
functional impairments functional impairments and recovery based on of an individual to recommendations for
related to cognitive related to cognitive assessment of determine functional use of interventions as it
and/or physical deficits and/or physical functional impairments goals and prognosis relates to improving
functional outcomes and
discussing prognosis
Demonstrates Selects and implements Interprets assessment Exhibits differential Demonstrates
knowledge of an assessment tool to tools used to assist in uses and limitations of knowledge of
commonly used assist with functional determining functional assessment tools for controversial and
assessment tools in evaluations outcomes determinants of emerging evaluations for
brain injury medicine functional outcomes functional outcome
Comments:
Not Yet Completed Level 1
Not Yet Assessable
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8Version 2 Brain Injury Medicine, ACGME Report Worksheet
Medical Knowledge 3: Clinical Reasoning
Level 1 Level 2 Level 3 Level 4 Level 5
Identifies salient Develops a prioritized Develops a prioritized Synthesizes Uses new and emerging
elements of a patient differential diagnosis for differential diagnosis for information to reach data to critically evaluate
presentation to inform common presentations complex presentations high-probability complex undiagnosed
clinical reasoning diagnoses with cases
continuous re-
appraisal to minimize
clinical reasoning
errors
Identifies diagnostic Identifies diagnostic Prioritizes the Considers diagnostic Mentors others on the
studies for common studies for conditions sequence and urgency testing based on cost identification of cost-
medical conditions commonly seen in brain of diagnostic testing effectiveness and effective, high-yield
injury medicine practice likelihood that results diagnostic testing
will influence clinical
management
Identifies common Describes types of Demonstrates a Anticipates and Mentors others on
causes of clinical clinical reasoning errors structured approach to accounts for errors and minimizing clinical
reasoning error within patient care personally identify biases reasoning errors
clinical reasoning errors
Comments:
Not Yet Completed Level 1
Not Yet Assessable
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9Version 2 Brain Injury Medicine, ACGME Report Worksheet
Systems-Based Practice 1: Patient Safety
Level 1 Level 2 Level 3 Level 4 Level 5
Demonstrates Identifies system factors Participates in analysis Conducts analysis of Actively engages teams
knowledge of common that lead to patient of patient safety events patient safety events and processes to modify
patient safety events safety events (simulated or actual) and offers error systems to prevent
prevention strategies patient safety events
(simulated or actual)
Demonstrates Reports patient safety Participates in Discloses patient Mentors others in the
knowledge of how to events through disclosure of patient safety events to disclosure of patient
report patient safety institutional reporting safety events to patients patients and safety events
events systems (simulated or and families/caregivers families/caregivers
actual) (simulated or actual) (simulated or actual)
Comments:
Not Yet Completed Level 1
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Systems-Based Practice 2: Quality Improvement
Level 1 Level 2 Level 3 Level 4 Level 5
Demonstrates Describes quality Participates in quality Demonstrates the skills Creates, implements,
knowledge of basic improvement initiatives improvement initiatives required to identify, and assesses quality
quality improvement and how to be involved develop, implement, improvement initiatives
methodologies and and analyze a quality at the institutional or
metrics improvement project community level
Comments:
Not Yet Completed Level 1
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Systems-Based Practice 3: System Navigation for Patient-Centered Care
Level 1 Level 2 Level 3 Level 4 Level 5
Demonstrates Coordinates care of Coordinates care of Role models effective Analyzes the process of
knowledge of care patients in routine patients in complex coordination of care coordination and
coordination clinical situations clinical situations patient-centered care leads in the design and
effectively using the effectively collaborating in collaboration with implementation of
roles of the with members of the different professions improvements
interprofessional team interprofessional teams and specialties
members
Identifies key elements Performs safe and Performs safe and Role models and Improves quality of
for safe and effective effective transitions of effective transitions of advocates for safe and transitions of care within
transitions of care and care/hand-offs in care/hand-offs in effective transitions of and across health care
hand-offs routine clinical complex clinical care/hand-offs within delivery systems to
situations situations and across health care optimize patient
delivery systems and outcomes
settings
Demonstrates Identifies specific Uses local resources Participates in Leads innovations and
knowledge of population and effectively to meet the changing and adapting advocacy in partnership
population and community health needs of a patient practice to provide for with populations and
community health needs and inequities for population and the needs of specific communities
needs and disparities their local population community while populations experiencing health care
minimizing health care inequities
inequities
Comments:
Not Yet Completed Level 1
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Systems-Based Practice 4: Physician Role in Health Care Systems
Level 1 Level 2 Level 3 Level 4 Level 5
Identifies key Describes how Discusses how Navigates the various Advocates for or leads
components of the components of a individual practice components of the systems change that
complex health care complex health care affects the broader complex health care enhances high value,
system, including the system are interrelated, system (e.g., length of system to provide efficient, and effective
various venues for post- and how this impacts stay, readmission rates, efficient and effective patient care and
acute care patient care clinical efficiency) patient care and transition of care
transition of care
Describes basic health Delivers care with Engages with patients Advocates for patient Participates in health
payment systems (e.g., consideration of each in shared decision care needs (e.g., policy advocacy
government, private, patient’s payment making, informed by community resources, activities
public, uninsured care) model (e.g., insurance each patient’s payment patient assistance
and practice models type) models resources) with
consideration of the
limitations of each
patient’s payment
model
Identifies basic Demonstrates use of Describes core Analyzes individual
knowledge domains for information technology administrative practice patterns and
effective transition to required for medical knowledge needed for professional
practice (e.g., practice (e.g., electronic transition to practice requirements in
information technology, health record, (e.g., contract preparation for
legal, billing and coding, documentation required negotiations, independent practice
financial, personnel) for billing and coding) malpractice insurance,
government regulation,
compliance)
Comments:
Not Yet Completed Level 1
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Practice-Based Learning and Improvement 1: Evidence-Based and Informed Practice
Level 1 Level 2 Level 3 Level 4 Level 5
Demonstrates how to Locates clinical Integrates clinical Critically appraises Educates others on how
access clinical evidence and formulates evidence with practice of and applies clinical critically appraise and
evidence basic treatment patient care of complex evidence to individual apply evidence to
recommendations patients patient care individual patient care
Articulates a summary Develops clinical Locates and applies Integrates conflicting Develops evidence-
and use of the questions and searches hierarchal clinical evidence to tailor based treatment
available evidence the available evidence evidence in the care of recommendations to guidelines
patients individual patient care
Comments:
Not Yet Completed Level 1
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Practice-Based Learning and Improvement 2: Reflective Practice and Commitment to Professional Growth
Level 1 Level 2 Level 3 Level 4 Level 5
Accepts responsibility Demonstrates Seeks and incorporates Seeks and Role models
for professional openness to performance feedback incorporates consistently seeking and
development and performance feedback episodically, with performance feedback incorporating
establishing goals to inform goals openness and humility consistently, with performance feedback
openness and humility
Identifies and analyzes Reflects on the factors Reflects and institutes Re-evaluates the Coaches others on
performance gaps which contribute to behavioral changes to effectiveness of reflective practice to
between one’s performance gaps narrow performance behavioral changes improve performance
expected and actual gaps and modifies when gaps
performance necessary
Seeks opportunities to Designs and Independently designs Uses performance Facilitates the design
improve through an implements a learning and implements a feedback to measure and implementation of
assisted learning plan plan with assistance learning plan and modify the learning plans for others
effectiveness of a
learning plan
Comments:
Not Yet Completed Level 1
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Professionalism 1: Ethics
Level 1 Level 2 Level 3 Level 4 Level 5
Demonstrates Analyzes Analyzes complex Recognizes conflicting Serves as a resource
knowledge of core straightforward situations using ethical ethical dilemmas and for others to resolve
ethical principles situations using ethical principles and resourcefully manages complex ethical
principles seeks guidance for and resolves them challenges
resolution using appropriate
resources
Comments:
Not Yet Completed Level 1
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Professionalism 2: Professional Behaviors
Level 1 Level 2 Level 3 Level 4 Level 5
Identifies and describes Demonstrates Demonstrates Recognizes and Role models
core professional professional behavior in professional behavior in manages dilemmas that professional behavior
behavior routine situations complex or stressful may trigger lapses in
situations professional behavior
Approaches clinical Describes situations to Takes responsibility for Proactively intervenes Identifies and
care with recognition of appropriately report own professionalism to prevent addresses system-
how professional professionalism lapses lapses and responds professionalism lapses based factors that
behavior can affect in self and others appropriately in self and others affects professionalism
others
Comments:
Not Yet Completed Level 1
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Professionalism 3: Accountability
Level 1 Level 2 Level 3 Level 4 Level 5
Responds promptly to Performs tasks and Performs tasks and Proactively implements Mentors others to
requests or reminders responsibilities in a responsibilities in a strategies to ensure that optimize timely task
to complete timely manner with timely manner with the needs of patients, completion
responsibilities appropriate attention to appropriate attention to family members,
detail in routine detail in complex or caregivers, teams, and
situations stressful situations systems are met in a
timely manner
Comments:
Not Yet Completed Level 1
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Professionalism 4: Patient Care Etiquette with Patients of All Abilities
Level 1 Level 2 Level 3 Level 4 Level 5
Recognizes the need to Demonstrates specific Maintains patient’s and Maintains patient’s and Mentors and is a
respect the dignity of all elements of verbal and family’s/caregiver’s family’s/caregiver’s resource for others by
patients and patient physical communication comfort and dignity comfort and dignity coaching them in
families/caregivers that reflect respect for during history taking during history taking behaviors and actions
regardless of people with and physical and physical that optimize the
impairments or impairments or examination for those examination for those comfort, dignity, and
disabilities disabilities with mild impairments with severe respect of people with
or disabilities impairments or impairments or
disabilities disabilities
Comments:
Not Yet Completed Level 1
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Professionalism 5: Fellow Well-Being and Help-Seeking
Level 1 Level 2 Level 3 Level 4 Level 5
Recognizes status of Independently With assistance, Independently Mentors others and
personal and recognizes status of proposes, implements, develops, implements, addresses system
professional well-being, personal and and refines a plan to and refines a plan to barriers and facilitators
with assistance professional well-being optimize personal and optimize personal and to optimize personal
and demonstrates professional well-being professional well-being and professional well-
appropriate help- for oneself and others for oneself and others being for oneself and
seeking behaviors others
Comments:
Not Yet Completed Level 1
This subcompetency is not intended to evaluate a fellow’s well-being. Rather, the intent is to ensure that each fellow has the fundamental knowledge of
factors that impact well-being, the mechanism by which those factors impact well-being, and available resources and tools to improve well-being.
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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 Establishes a Easily establishes Mentors others in
non-verbal behavior to therapeutic relationship therapeutic relationship therapeutic developing positive
demonstrate respect in straightforward in challenging patient relationships, with therapeutic
and establish rapport encounters using active encounters attention to relationships
listening and clear patient/patient
language family/caregiver
concerns and context,
regardless of
complexity
Mitigates common Mitigates complex When prompted, Overcomes personal Mentors others in self-
barriers to effective barriers to effective reflects on personal biases while proactively awareness practice
communication (e.g., communication (e.g., biases while attempting mitigating while teaching a
language, disability) health literacy, cultural to mitigate communication barriers contextual approach to
differences) communication barriers mitigate communication
barriers
Accurately Organizes and initiates With guidance, Independently, uses Mentors others in
communicates one’s communication with sensitively and shared decision making shared decision making
own role within the patient/patient compassionately to align patient and in patient and patient
health care system family/caregiver by delivers medical patient family/caregiver family/caregiver
clarifying expectations information, elicits values, goals, and communication
and verifying patient and patient preferences with including those with a
understanding of the family/caregiver values, treatment options to high degree of
clinical situation goals and preferences, make a personalized uncertainty/conflict
and acknowledges care plan
uncertainty and conflict
Comments:
Not Yet Completed Level 1
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Interpersonal and Communication Skills 2: Interprofessional and Team Communication
Level 1 Level 2 Level 3 Level 4 Level 5
Uses respectful Communicates Checks one’s own Coordinates Role models flexible
language that values all information effectively understanding while recommendations and communication
health care team with all health care listening to adapt communication from strategies that value
members team members communication style to different health care input from all health
fit team needs team members to care team members,
optimize patient care resolving conflict when
needed
Understands the need Solicits feedback on Communicates Communicates Facilitates regular
and benefit of receiving performance as a concerns and provides feedback and health care team-based
feedback on health care team feedback to health care constructive criticism to feedback in complex
performance from the member team members superiors situations
health care team
Comments:
Not Yet Completed Level 1
©2021 Accreditation Council for Graduate Medical Education (ACGME)
All rights reserved except the copyright owners grant third parties the right to use the Brain Injury Medicine Milestones on a non-exclusive basis for educational purposes.
22Version 2 Brain Injury Medicine, ACGME Report Worksheet
Interpersonal and Communication Skills 3: Communication within Health Care Systems
Level 1 Level 2 Level 3 Level 4 Level 5
Accurately records Demonstrates Communicates clearly, Provides feedback to Models feedback to
information in the organized and complete concisely, timely, and in improve others’ written improve others’ written
patient record while diagnostic and an organized written communication communication
safeguarding patient therapeutic reasoning form, including
personal health through notes in the anticipatory
information patient record, including recommendations
appropriate
modifications when
using copy-and-paste
function
Demonstrates basic Communicates through Appropriately selects Achieves written or Guides departmental or
knowledge of appropriate channels as direct (e.g., telephone, verbal communication institutional
appropriate channels of required by institutional in-person) and indirect that serves as an communication around
communication within policy (e.g., patient (e.g., progress notes, example for others to policies and procedures
the institution (e.g., safety reports) text messages) forms of follow
pager callback, timely communication based
response to emails) on context
Comments:
Not Yet Completed Level 1
©2021 Accreditation Council for Graduate Medical Education (ACGME)
All rights reserved except the copyright owners grant third parties the right to use the Brain Injury Medicine Milestones on a non-exclusive basis for educational purposes.
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