Blood Banking/Transfusion Medicine Milestones - ACGME
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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 purposes. 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 educational purposes. 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
Version 2 Blood Banking/Transfusion Medicine Milestones, ACGME Report Worksheet 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
Version 2 Blood Banking/Transfusion Medicine Milestones, ACGME Report Worksheet 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
Version 2 Blood Banking/Transfusion Medicine Milestones, ACGME Report Worksheet 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
Version 2 Blood Banking/Transfusion Medicine Milestones, ACGME Report Worksheet 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
Version 2 Blood Banking/Transfusion Medicine Milestones, ACGME Report Worksheet 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. 16
Version 2 Blood Banking/Transfusion Medicine Milestones, ACGME Report Worksheet 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. 17
Version 2 Blood Banking/Transfusion Medicine Milestones, ACGME Report Worksheet 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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