ACGME and vocabulary

I just returned from the ACGME Annual Education meeting in Nashville on Saturday. It was a really good meeting with great plenary speakers, and the opportunity for me to network with others who are interested in developing Program Director Training Programs at there institutions.

I want to start out positive, because I will quickly reverse direction and explode with frustration. As a faculty development professional, I have spent many years "translating" the educational concepts central to the "Outcomes Project" to our PD's and faculty. Competencies, competency-based learning objectives, and benchmarks were all new concepts to many of the PD's. All are smart people, many of whom sincerely wanted to understand how this new approach to education would benefit their residents. Ultimately we have made great progress.

Now,... new leadership, new vocabulary! The "Milestone Project" has recently been established. I went to one meeting at which a whole new set of terms were identified. Entrustable Professional Activities (EPA's), Landmarks and Milestones were introduced. The presenters had good slides and spent time educating us about the use of these new concepts in planning program development and evaluation. All the concepts seemed educationally sound.

That said, where do we start? Are milestones, that are determined by each specific discipline (Internal medicine has identified 142) like objectives or are they different? What is the difference between "landmarks" and "benchmarks". If after 25 years in education, I'm confused... imagine our PD's who have a few other things on their minds.

Things change... I get it! However, it sure would be great if these changes came with a logical "bridge" between old and new language and rationales for change.