Abdominal Radiology Milestones - The Accreditation Council for Graduate Medical Education - ACGME

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Abdominal Radiology Milestones - The Accreditation Council for Graduate Medical Education - ACGME
Abdominal Radiology Milestones
                                         The Accreditation Council for Graduate Medical Education

                                                                  Implementation Date: July 1, 2022
                                                                     Second Revision: July 2021
                                                                    First Revision: February 2014

©2021 Accreditation Council for Graduate Medical Education (ACGME)
All rights reserved except the copyright owners grant third parties the right to use the Abdominal Radiology Milestones on a non-exclusive basis for educational purposes.
                                                                                                                                                                             i
Abdominal Radiology 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 competency 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 Abdominal Radiology Milestones on a non-exclusive basis for educational purposes.
                                                                                                                                                                             ii
Abdominal Radiology Milestones

                                                                             Work Group
                                 Kamran Ali, MD                                                                         Sydney McLean, MHA
                                Dennis Balfe, MD                                                                           Marco Molina, MD
                           Laura Edgar, EdD, CAE                                                                         Desiree Morgan, MD
                             C. Dan Johnson, MD                                                                             Anup Shetty, MD
                                  David Kim, MD

The ACGME would like to thank the following organizations for their continued support in the
development of the Milestones:
                                                                American Board of Radiology
                                                      ACGME Review Committee for Radiology

©2021 Accreditation Council for Graduate Medical Education (ACGME)
All rights reserved except the copyright owners grant third parties the right to use the Abdominal Radiology Milestones on a non-exclusive basis for educational purposes.
                                                                                                                                                                             iii
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 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 fellow 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).

©2021 Accreditation Council for Graduate Medical Education (ACGME)
All rights reserved except the copyright owners grant third parties the right to use the Abdominal Radiology Milestones on a non-exclusive basis for educational purposes.
                                                                                                                                                                             iv
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.

Examples are provided for some milestones within this document. Please note: the examples are not the required element or
outcome; they are provided as a way to share the intent of the element.

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)
All rights reserved except the copyright owners grant third parties the right to use the Abdominal Radiology Milestones on a non-exclusive basis for educational purposes.
                                                                                                                                                                             v
The diagram below presents an example set of milestones for one sub-competency in the same format as the ACGME
         Report Worksheet. For each reporting period, a fellow’s performance on the milestones for each sub-competency 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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All rights reserved except the copyright owners grant third parties the right to use the Abdominal Radiology Milestones on a non-exclusive basis for educational purposes.
                                                                                                                                                                             vi
Version 2                                                     Abdominal Radiology, ACGME Report Worksheet

 Patient Care 1: Consultant

 Level 1                           Level 2                            Level 3                            Level 4                          Level 5
 For routine radiology             For complex radiology              Manages radiology                  Provides                         Participates in research,
 consultations, delineates         consultations, delineates          consultations                      comprehensive                    development, and
 the clinical question,            the clinical question,             independently, taking into         radiology consultations          implementation of
 obtains appropriate               obtains appropriate                consideration cost                 at the expected level of         abdominal imaging
 clinical information, uses        clinical information, uses         effectiveness and risk             an abdominal                     guidelines
 evidence-based imaging            evidence-based imaging             benefit analysis                   radiologist
 guidelines, and                   guidelines, and
 recommends next steps             recommends next steps
 with assistance                   with assistance

 Comments:
                                                                                                                              Not Yet Completed Level 1
                                                                                                                              Not Yet Assessable

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Version 2                                                     Abdominal Radiology, ACGME Report Worksheet

 Patient Care 2: Competence in Procedures

 Level 1                           Level 2                            Level 3                            Level 4                          Level 5
 Performs simple                   Competently performs               Proficiently performs              Proficiently and                 Participates in research or
 procedures, with direct           simple procedures, with            simple and complex                 independently performs           innovation involving
 supervision                       indirect supervision and           procedures, with indirect          simple and complex               abdominal imaging
                                   complex procedures, with           supervision                        procedures                       procedures
                                   direct supervision

 Recognizes                        Manages complications of           Anticipates and                    Proficiently and                 Participates in research
 complications of                  procedures, with                   independently manages              independently manages            on innovative methods
 procedures and enlists            supervision                        complications of                   complications of                 designed to reduce
 help                                                                 procedures                         procedures                       procedural complications

                                   Mentors learners on the            Instructs learners on              Instructs learners on            Develops educational
                                   indications for procedures         performing simple                  performing simple and            materials for learners
                                   and management of                  procedures and managing            complex procedures               regarding procedures
                                   complications                      complications                      and managing
                                                                                                         complications

 Comments:
                                                                                                                            Not Yet Completed Level 1
                                                                                                                            Not Yet Assessable

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All rights reserved except the copyright owners grant third parties the right to use the Abdominal Radiology Milestones on a non-exclusive basis for educational purposes.
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Version 2                                                     Abdominal Radiology, ACGME Report Worksheet

 Patient Care 3: Image Interpretation

 Level 1                           Level 2                            Level 3                            Level 4                          Level 5
 Identifies primary,               Prioritizes differential           Provides a single                  Demonstrates expertise           Integrates state-of-the-art
 secondary, and critical           diagnoses and                      diagnosis with integration         in diagnosis at a level          research and literature
 imaging findings and              recommends                         of current guidelines to           expected of an                   into image interpretation
 formulates differential           management options                 recommend management,              abdominal radiologist
 diagnoses                                                            when appropriate

 Comments:
                                                                                                                            Not Yet Completed Level 1
                                                                                                                            Not Yet Assessable

©2021 Accreditation Council for Graduate Medical Education (ACGME)
All rights reserved except the copyright owners grant third parties the right to use the Abdominal Radiology Milestones on a non-exclusive basis for educational purposes.
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Version 2                                                     Abdominal Radiology, ACGME Report Worksheet

 Medical Knowledge 1: Imaging Technology and Physics

 Level 1                           Level 2                            Level 3                            Level 4                          Level 5
 Demonstrates                      Demonstrates knowledge             Proficiently optimizes             Demonstrates expertise           Presents or publishes
 knowledge of basic                of instrument quality              image acquisition and              in image acquisition and         research on imaging
 image acquisition and             control and image                  processing in                      processing optimization,         technology
 image processing, and             reconstruction and                 collaboration with the             and provides instruction
 recognizes common                 troubleshoots for artifact         technology/imaging team            to trainees and imaging
 imaging artifacts and             reduction                                                             team
 technical problems

 Applies knowledge of              Demonstrates knowledge             Applies physical principles        Teaches principles of
 basic medical physics             of more advanced                   to optimize dose reduction         physics and dose
 and radiobiology to               medical physics and                in abdominal imaging               optimization to learners
 abdominal imaging                 radiobiology to abdominal
                                   imaging

 Comments:
                                                                                                                            Not Yet Completed Level 1
                                                                                                                            Not Yet Assessable

©2021 Accreditation Council for Graduate Medical Education (ACGME)
All rights reserved except the copyright owners grant third parties the right to use the Abdominal Radiology Milestones on a non-exclusive basis for educational purposes.
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Version 2                                                     Abdominal Radiology, ACGME Report Worksheet

 Medical Knowledge 2: Protocol Selection and Contrast Agent Selection/Dosing

 Level 1                           Level 2                            Level 3                            Level 4                          Level 5
 Discusses the protocols           Selects appropriate                Selects appropriate                Modifies protocols and           Develops and implements
 and contrast agent/dose           protocols and contrast             protocols and contrast             contrast agent/dose as           imaging protocols
 for abdominal imaging             agent/dose for routine             agent/dose for complex             determined by clinical
                                   abdominal imaging                  abdominal imaging                  circumstances

 Comments:
                                                                                                                            Not Yet Completed Level 1
                                                                                                                            Not Yet Assessable

©2021 Accreditation Council for Graduate Medical Education (ACGME)
All rights reserved except the copyright owners grant third parties the right to use the Abdominal Radiology Milestones on a non-exclusive basis for educational purposes.
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Version 2                                                     Abdominal Radiology, 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 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 patients and           others in the disclosure of
 report patient safety             institutional reporting            patients and families              families (simulated or           patient safety events
 events                            systems (simulated or              (simulated or actual)              actual)
                                   actual)

 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 Abdominal Radiology Milestones on a non-exclusive basis for educational purposes.
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Version 2                                                     Abdominal Radiology, ACGME Report Worksheet

 Systems-Based Practice 2: Quality Improvement

 Level 1                           Level 2                            Level 3                            Level 4                          Level 5
 Demonstrates                      Describes local quality            Participates in local              Demonstrates the skills          Creates, implements, and
 knowledge of basic                improvement initiatives            quality improvement                required to identify,            assesses quality
 quality improvement                                                  initiatives                        develop, implement,              improvement initiatives at
 methodologies and                                                                                       and analyze a quality            the institutional or
 metrics                                                                                                 improvement project              community level

 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 Abdominal Radiology Milestones on a non-exclusive basis for educational purposes.
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Version 2                                                     Abdominal Radiology, ACGME Report Worksheet

 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 patient-         care coordination and
 coordination in radiology         radiology                          radiology                          centered care among              leads in the design and
 imaging/procedures                imaging/procedures                 imaging/procedures                 different disciplines and        implementation of
                                   effectively using the roles        effectively using the roles        specialties                      improvements
                                   of interprofessional teams         of interprofessional teams

 Identifies key elements           Performs safe and                  Performs safe and                  Role models safe and             Improves quality of
 for safe and effective            effective transitions of           effective transitions of           effective transitions of         transitions of care to
 transitions of care and           care/hand-offs in routine          care/hand-offs in complex          care/hand-offs                   optimize patient outcomes
 hand-offs                         clinical situations                clinical situations

 Demonstrates                      Identifies specific                Identifies local resources         Participates in adapting         Leads innovations and
 knowledge of population           population and                     available to meet the              the practice to provide          advocates for populations
 and community health              community health needs             needs of a patient                 for the needs of specific        and communities with
 needs and disparities             and inequities for their           population and                     populations (actual or           health care inequities
                                   local population                   community                          simulated)

 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 Abdominal Radiology Milestones on a non-exclusive basis for educational purposes.
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Version 2                                                     Abdominal Radiology, ACGME Report Worksheet

 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 individual           Manages various                  Advocates for or leads
 components of the                 components of a complex            practice affects the               components of the                systems change that
 complex healthcare                health care system are             broader system (e.g.,              complex health care              enhances high-value,
 system (e.g., hospital,           interrelated, and how this         length of stay,                    system to provide                efficient, and effective
 finance, personnel,               impacts patient care               readmission rates, clinical        efficient and effective          patient care and transition
 technology)                                                          efficiency)                        patient care and                 of care
                                                                                                         transition of care

 Describes the                     States relative cost of            Describes the technical            Describes the radiology          Participates in health
 mechanisms for                    common abdominal                   and professional                   revenue cycle and                policy advocacy activities
 reimbursement, including          radiology procedures               components of imaging              measurements of
 types of payors                                                      costs                              productivity (e.g.,
                                                                                                         relative value units)

 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 Abdominal Radiology Milestones on a non-exclusive basis for educational purposes.
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Version 2                                                     Abdominal Radiology, ACGME Report Worksheet

 Systems-Based Practice 5: Contrast Agent Safety

 Level 1                           Level 2                            Level 3                            Level 4                          Level 5
 Demonstrates                      Recognizes contrast                Manages contrast                   Independently manages            Leads educational
 knowledge of contrast             reactions (simulated or            reactions, with                    contrast reactions               experience in simulation
 reactions, and efficiently        actual), and identifies            supervision (simulated or          (simulated or actual)            laboratory for contrast
 accesses critical                 specific patient-based             actual)                                                             reaction
 resources for                     management issues
 management

 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 Abdominal Radiology Milestones on a non-exclusive basis for educational purposes.
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Version 2                                                     Abdominal Radiology, ACGME Report Worksheet

 Systems-Based Practice 6: Radiation Safety

 Level 1                           Level 2                            Level 3                            Level 4                          Level 5
 Demonstrates                      Accesses resources to              Communicates the                   Applies principles of            Creates, implements, and
 knowledge of the                  determine exam-specific            relative risk of exam-             ALARA in daily practice,         assesses radiation safety
 mechanisms of radiation           average radiation dose             specific radiation                 including methods of             initiatives at the
 injury and the ALARA              information                        exposure to patients and           dose reduction and               institutional level
 (“as low as reasonably                                               practitioners                      image optimization in
 achievable”) concept                                                                                    fluoroscopy and
                                                                                                         computerized
                                                                                                         tomography (CT)

 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 Abdominal Radiology Milestones on a non-exclusive basis for educational purposes.
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Version 2                                                     Abdominal Radiology, ACGME Report Worksheet

 Systems-Based Practice 7: Magnetic Resonance (MR) Safety

 Level 1                           Level 2                            Level 3                            Level 4                          Level 5
 Demonstrates                      Accesses resources to              Communicates MR                    Applies principles of MR         Creates, implements, and
 knowledge of the risks of         determine the safety of            safety, including implants         safety to daily practice         assesses MR safety
 magnetic resonance                implanted devices and              and retained foreign                                                initiatives at the
 imaging (MRI), including          retained foreign bodies            bodies, to patients and                                             institutional level
 safety zones and pre-MR                                              practitioners
 screening

 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 Abdominal Radiology Milestones on a non-exclusive basis for educational purposes.
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Version 2                                                     Abdominal Radiology, ACGME Report Worksheet

 Practice-Based Learning and Improvement 1: Evidence-Based and Informed Practice

 Level 1                           Level 2                            Level 3                            Level 4                          Level 5
 Demonstrates how to               Articulates clinical               Locates and applies the            Critically appraises             Coaches others to
 access and use available          questions and elicits              best available evidence,           conflicting evidence to          critically appraise and
 evidence to determine             patient preferences and            integrated with patient            guide care, tailored to          apply evidence for
 the best imaging                  values in order to guide           preferences and values,            the individual patient           complex patients; and/or
 examination for a routine         evidence-based imaging             to the care of complex                                              participates in the
 patient/diagnosis                                                    patients                                                            development of guidelines

 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 Abdominal Radiology Milestones on a non-exclusive basis for educational purposes.
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Version 2                                                     Abdominal Radiology, ACGME Report Worksheet

 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 for        Receptive to performance           Episodically seeks                 Consistently seeks               Coaches other learners to
 professional                      data and feedback in               performance data and               performance data and             consistently seek
 development by                    order to adjust goals              feedback, with humility            feedback with humility           performance data and
 establishing goals                                                   and adaptability                   and adaptability                 feedback

 Identifies factors which          Analyzes and reflects on           Analyzes, reflects on, and         Analyzes effectiveness           Coaches others on
 contribute to gap(s)              factors which contribute to        institutes behavioral              of behavioral changes            reflective practice
 between expectations              gap(s) between                     change(s) to narrow the            where appropriate and
 and actual performance            expectations and actual            gap(s) between                     considers alternatives in
                                   performance                        expectations and actual            narrowing the gap(s)
                                                                      performance                        between expectations
                                                                                                         and actual performance

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

 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 Abdominal Radiology Milestones on a non-exclusive basis for educational purposes.
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Version 2                                                     Abdominal Radiology, ACGME Report Worksheet

 Professionalism 1: Professional Behavior and Ethical Principles

 Level 1                           Level 2                            Level 3                            Level 4                          Level 5
 Demonstrates                      Demonstrates insight into          Demonstrates                       Recognizes situations            Coaches others when
 knowledge of                      professional behavior in           professional behavior in           that may trigger                 their behavior fails to
 expectations for                  routine situations and             complex or stressful               professionalism lapses           meet professional
 professional behavior             takes responsibility for           situations                         and intervenes to                expectations
 and describes how to              own professionalism                                                   prevent lapses in self
 appropriately report              lapses                                                                and others
 professional lapses

 Demonstrates                      Analyzes straightforward           Recognizes need to seek            Recognizes and uses              Identifies and seeks to
 knowledge of the ethical          situations using ethical           help in managing and               appropriate resources            address system-level
 principles underlying             principles                         resolving complex ethical          for managing and                 factors that induce or
 informed consent,                                                    situations                         resolving ethical                exacerbate ethical
 surrogate decision                                                                                      dilemmas as needed               problems or impede their
 making, advance                                                                                         (e.g., ethics                    resolution
 directives, confidentiality,                                                                            consultations, literature
 error disclosure, and                                                                                   review, risk
 stewardship of limited                                                                                  management/legal
 resources                                                                                               consultation)

 Comments:
                                                                                                                            Not Yet Completed Level 1

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All rights reserved except the copyright owners grant third parties the right to use the Abdominal Radiology Milestones on a non-exclusive basis for educational purposes.
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Version 2                                                     Abdominal Radiology, ACGME Report Worksheet

 Professionalism 2: Accountability/Conscientiousness

 Level 1                           Level 2                            Level 3                            Level 4                          Level 5
 Responds promptly to              Performs tasks and                 Performs tasks and                 Recognizes and raises            Takes ownership of
 requests or reminders to          responsibilities in a timely       responsibilities in a timely       awareness of situations          system outcomes
 complete tasks and                manner to ensure that the          manner to ensure that the          that may impact others’
 responsibilities                  needs of patients, teams,          needs of patients, teams,          ability to complete tasks
                                   and systems are met in             and systems are met in             and responsibilities in a
                                   routine situations                 complex or stressful               timely manner
                                                                      situations

 Comments:
                                                                                                                            Not Yet Completed Level 1

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All rights reserved except the copyright owners grant third parties the right to use the Abdominal Radiology Milestones on a non-exclusive basis for educational purposes.
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Version 2                                                     Abdominal Radiology, ACGME Report Worksheet

 Professionalism 3: Self-Awareness and Help-Seeking

 Level 1                           Level 2                            Level 3                            Level 4                          Level 5
 Recognizes status of              Independently recognizes           With assistance,                   Independently develops           Coaches others when
 personal and                      status of personal and             proposes a plan to                 a plan to optimize               emotional responses or
 professional well-being,          professional well-being            optimize personal and              personal and                     limitations in
 with assistance, and is           using available resources          professional well-being            professional well-being          knowledge/skills do not
 aware of available                when appropriate                                                                                       meet professional
 resources                                                                                                                                expectations

 Recognizes limits in the          Independently recognizes           With assistance,                   Independently develops
 knowledge/skills of self          limits in the                      proposes a plan to                 a plan to remediate or
 or team, with assistance          knowledge/skills of self or        remediate or improve               improve limits in the
                                   team and demonstrates              limits in the knowledge/           knowledge/skills of self
                                   appropriate help-seeking           skills of self or team             or team
                                   behaviors

 Comments:
                                                                                                                            Not Yet Completed Level 1

This subcompetency is not intended to evaluate a fellow’s well-being, but to ensure each fellow has the fundamental knowledge of factors that impact well-
being, the mechanisms by which those factors impact well-being, and available resources and tools to improve well-being.

©2021 Accreditation Council for Graduate Medical Education (ACGME)
All rights reserved except the copyright owners grant third parties the right to use the Abdominal Radiology Milestones on a non-exclusive basis for educational purposes.
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Version 2                                                     Abdominal Radiology, ACGME Report Worksheet

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

 Level 1                           Level 2                            Level 3                            Level 4                          Level 5
 Accurately                        Identifies barriers to             Identifies biases that             Actively minimizes               Coaches other learners to
 communicates own role             effective communication            hinder effective                   communication barriers           minimize communication
 within the health care            (e.g., language, health            communication                                                       barriers
 system                            literacy, cultural)

 Identifies the need to            Organizes and initiates            With guidance, sensitively         Independently, uses              Coaches other learners in
 adjust communication              communication with                 and compassionately                shared decision making           shared decision making
 strategies based on               patient/family by clarifying       delivers medical                   to align patient goals,
 assessment of                     expectations and verifying         information, elicits patient       and preferences with
 patient/family                    understanding of the               goals and preferences,             treatment options to
 expectations and                  clinical situation                 and acknowledges                   make a personalized
 understanding of their                                               uncertainty and conflict           care plan
 health status and
 treatment options

 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 Abdominal Radiology Milestones on a non-exclusive basis for educational purposes.
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Version 2                                                     Abdominal Radiology, ACGME Report Worksheet

 Interpersonal and Communication Skills 2: Interprofessional and Team Communication

 Level 1                           Level 2                            Level 3                            Level 4                          Level 5
 Clearly and concisely             Checks understanding of            Coordinates                        Role models flexible             Coaches other learners in
 responds to a                     recommendations when               recommendations from               communication                    tailored communications
 consultation request              providing consultation             different members of the           strategies that value            to referring providers
                                                                      health care team to                input from all health
                                                                      optimize patient care              care team members,
                                                                                                         resolving conflict when
                                                                                                         needed
 Communicates emergent             Communicates non-                  Communicates findings
 findings according to             emergent findings where            and management options
 institutional or national         failure to act may                 (as appropriate) which are
 guidelines                        adversely affect patient           tailored to the referring
                                   outcome                            provider

 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 Abdominal Radiology Milestones on a non-exclusive basis for educational purposes.
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Version 2                                                     Abdominal Radiology, ACGME Report Worksheet

 Interpersonal and Communication Skills 3: Communication within Health Care Systems

 Level 1                           Level 2                            Level 3                            Level 4                          Level 5
 Demonstrates                      Communicates systems               Communicates clear and             Facilitates dialogue             Teaches and/or conducts
 knowledge of institutional        concerns in a respectful           constructive suggestions           regarding systems                research related to
 communications policies           manner                             to improve systems                 issues among larger              system and process
 and systems                                                                                             community stakeholders           improvement
                                                                                                         (institution, health care
                                                                                                         system, field)

 Comments:
                                                                                                                            Not Yet Completed Level 1

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All rights reserved except the copyright owners grant third parties the right to use the Abdominal Radiology Milestones on a non-exclusive basis for educational purposes.
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