Contextualization of Acgme Milestone Project and Its Integration with Entrustable Professional Activities (Epas) in Taiwan – a 3-Stage Educational Implementation in Anesthesiology Based on 4 Teaching Hospitals

A new era of competency-based medical education (CBME) has emerged since 2014 within ACGME’s new educational reform - Milestone Project. The project attempted to specify all detailed learning outcomes of ACGME 6 core competencies in different specialties. For example, an anesthesiologist has to achieve 284 milestones, which located within 25 sub-competencies, to demonstrate his/her clinical competence or excellence. To evaluate such a great amount of learning indicators in clinical setting, entrustable professional activites (EPAs) could be contextually designed to fit for the purpose. This 2-years project aims at accomplishing 3 tasks, which are 1) examining ACGME milestones in the spectrums of importance, relevance and observability by Delphi Technique by experts in anesthesiology nationwide; 2) prioritizing EPAs of different level through focus groups and Delphi method in the learning ennvironments of Taipei Medical University and National Taiwan University; and, 3) corresponding each EPA with the milestones and refining both of the constructed towards stabability by content analysis. In so doing, milestones can possibly be reduced to a manageable amount, entrusted as clinical activities or duties, and assessed in daily practice. This project aspires to facilitate CBME in Taiwan and set up a model for future specialty training collaboration in between the local and the global.