Development and Evaluation of Standardized Narrative Cases Depicting the General Surgery Professionalism Milestones

Residency programs now are required to use educational milestones, which has led to the need for new methods of assessment. The literature suggests that narrative cases are a promising tool to track residents’ progress. This study demonstrates the process for developing and evaluating narrative cases representing the five levels of the professionalism milestones. The authors developed 10 narrative cases, 2 for each of the 5 milestone levels. Each case contained at least 20 of the 28 behaviors identified in the Accreditation Council for Graduate Medical Education general surgery professionalism milestones. Mean faculty ratings matched the milestone levels. Reliability was good (G coefficient = 0.86, phi coefficient = 0.85), indicating consistency in raters’ ability to determine the proper milestone level for each case.