Anesthesiology Milestones

The Accreditation Council for Graduate Medical Education

Implementation Date: July 1, 2021

Second Revision: November 2020

First Revision: December 2013

i

Anesthesiology Milestones

The Milestones are designed only for use in evaluation of residents in the context of their participation in

ACGME-accredited residency programs. The Milestones provide a framework for the assessment of the

development of the resident 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.

ii

Anesthesiology Milestones

Work Group

Aditee Ambardekar, MD, MSEd

Kaitlyn Brennan, DO, MPH

Rupa Dainer, MD

Crys Draconi

Laura Edgar, EdD, CAE

Herodotos Ellinas, MD, MHPE

Martin Laskey, DO

Timothy Long, MD

Anne Marie McKenzie-Brown, MD

John Mitchell, MD

Carlos Trombetta, MD, MEd

Chelsia Varner Jackson, MD

Kathryn Walker, MD, MEd

Bradley Wargo, DO

The ACGME would like to thank the following organizations for their continued support in the

development of the Milestones:

American Board of Anesthesiology

American Osteopathic Association

American Osteopathic College of Anesthesiologists

Review Committee for Anesthesiology

Society for Education in Anesthesia

iii

Understanding Milestone Levels and Reporting

This document presents the Milestones, which programs use in a semi-annual review of resident 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 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 resident 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 resident may

achieve higher levels early in his/her educational program just as a senior resident 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. Residents 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 resident.

Selection of a level implies the resident substantially demonstrates the milestones in that level, as well as those in lower levels

(see the diagram on page vi).

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 resident 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 resident 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.

Supplemental Guides and other resources are available on the Milestones page of each specialty section of the ACGME website.

On www.acgme.org, choose the applicable specialty under the “Specialties” menu, then select the “Milestones” link in the lower

navigation bar.

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 resident’s performance on the milestones for each sub-competency will be

indicated by selecting the level of milestones that best describes that resident’s performance in relation to those milestones.

Selecting a response box in the

middle of a level implies that

milestones in that level and in lower

levels have been substantially

demonstrated.

Selecting a response box on the line in

between levels indicates that milestones

in lower levels have been substantially

demonstrated as well as some

milestones in the higher level(s).

Version 2 Anesthesiology, ACGME Report Worksheet

1

Patient Care 1: Pre-Anesthetic Evaluation

Level 1 Level 2 Level 3 Level 4 Level 5

Performs basic chart

review

Conducts patient

interview, with direct

supervision

Conducts and interprets

a physical examination,

with direct supervision

Performs focused chart

review, with indirect

supervision

Interviews the patient and

gathers pertinent

information, with indirect

supervision

Conducts a focused

physical examination, with

indirect supervision

Interprets chart review

information to assess

need for further work-up

Interprets information

collected during patient

interview, with assistance

Identifies comorbidities on

physical examination that

may require further

evaluation, with indirect

supervision

Evaluates diagnostic

data and provides risk

stratification based on

comorbidities and

anesthetic implications

Independently identifies

the need for additional

evaluation and suggests

therapeutic

interventions

Independently identifies

concerning physical

exam findings that

require further

evaluation

Independently identifies a

previously undiagnosed

condition

Comments:

Not Yet Completed Level 1

Not Yet Assessable

Version 2 Anesthesiology, ACGME Report Worksheet

2

Patient Care 2: Peri-Operative Care and Management

Level 1 Level 2 Level 3 Level 4 Level 5

Identifies the

components of an

anesthetic plan

Identifies the

components of a pain

management plan

Identifies potential

impact of anesthesia

beyond intra-operative

period

Develops an anesthetic

plan for a healthy patient

undergoing

uncomplicated

procedures

Implements simple peri-

operative pain

management plan

Identifies patient specific

risks factors for long-term

anesthetic effects

Develops an anesthetic

plan for patients with well-

controlled comorbidities

or undergoing

complicated procedures

Identifies patients with a

history of chronic pain

who require a modified

peri-operative pain

management plan

Develops the anesthetic

plan based on risk factors

to mitigate the long-term

impact of anesthesia

Develops an anesthetic

plan for patients with

multiple, uncontrolled

comorbidities, and

undergoing complicated

procedures

Implements the

anesthetic plan for

patients with complex

pain history and

polypharmacy

Implements the

anesthetic plan to

mitigate the long-term

impact of anesthesia

In collaboration with other

specialists, develops

protocols for multimodal

analgesia plan for

patients with a complex

pain history and

substance use disorder

Develops departmental or

institutional protocols for

reduction of the long-term

impact of anesthesia

Comments:

Not Yet Completed Level 1

Not Yet Assessable

Version 2 Anesthesiology, ACGME Report Worksheet

3

Patient Care 3: Application and Interpretation of Monitors

Level 1 Level 2 Level 3 Level 4 Level 5

Identifies standard

monitors

Applies standard

monitors to patients

Interprets standard

monitoring data

Independently selects

central and arterial

catheters based on

patient comorbidities and

procedure

Inserts central and arterial

catheters, with

supervision

Addresses malfunctions

in standard monitors and

interprets data from

central and arterial lines,

with supervision

Selects advanced

monitors based on patient

comorbidities and

procedure, with

supervision

Inserts or applies

advanced monitors, with

supervision

Recognizes and

addresses malfunctions in

advanced monitors and

interprets data, with

supervision

Independently selects

advanced monitors

based on patient

comorbidities and

procedure

Independently inserts or

applies advanced

invasive monitors

Independently interprets

data, recognizes, and

addresses malfunctions

in monitors and other

anesthesia equipment

Functions as a consultant

for difficult advanced

monitor placement

Participates in the

research and/or

development of protocols

for monitoring technology

Comments:

Not Yet Completed Level 1

Not Yet Assessable

Version 2 Anesthesiology, ACGME Report Worksheet

4

Patient Care 4: Intra-Operative Care

Level 1 Level 2 Level 3 Level 4 Level 5

Assists in the initiation of

the anesthetic

Assists in maintenance

of anesthetic care

Assists with emergence

from anesthesia

Plans and initiates the

anesthetic for healthy

patients undergoing

uncomplicated

procedures

Manages expected

events during anesthetic

care, with supervision

Anticipates and manages

expected events during

emergence, with

supervision

Plans and initiates the

anesthetic in a patient

with well-controlled

comorbidities, or

undergoing complicated

procedures

Independently manages

expected events during

anesthetic care

Anticipates and manages

unexpected events during

emergence, with

supervision

Independently plans

and initiates the

anesthetic in a patient

with multiple,

uncontrolled

comorbidities

undergoing complicated

procedures

Independently manages

unexpected events

during anesthetic care

Independently

anticipates and

manages unexpected

events during

emergence

Manages rare events

during anesthetic care

Manages rare events

during emergence

Comments:

Not Yet Completed Level 1

Not Yet Assessable

Version 2 Anesthesiology, ACGME Report Worksheet

5

Patient Care 5: Airway Management

Level 1 Level 2 Level 3 Level 4 Level 5

Performs basic airway

assessment

Performs bag-mask

ventilation in

uncomplicated airway

Uses the airway exam

and identifiable risk

factors to formulate a

patient-specific plan

Prepares basic equipment

and manages an

uncomplicated airway

Devises airway

management plans that

address contingencies,

with supervision

Prepares and

incorporates advanced

equipment in the

management of a

complicated airway, with

supervision

Independently devises

airway management

plans that address

contingencies

Independently prepares

and incorporates

advanced equipment in

the management of a

complicated airway

Functions as an expert in

an airway crisis for

complicated airways

Comments:

Not Yet Completed Level 1

Not Yet Assessable

Version 2 Anesthesiology, ACGME Report Worksheet

6

Patient Care 6: Point-of-Care Ultrasound

Level 1 Level 2 Level 3 Level 4 Level 5

Lists and explains the

basic science and

terminology of

ultrasound

Identifies relevant

anatomy using

ultrasound

Uses ultrasound for

vascular access in

routine situations, with

supervision

Selects ultrasound

equipment for

procedures, with

supervision

Conducts point-of-care

ultrasound, with

supervision

Uses ultrasound for

vascular access in routine

situations

Selects ultrasound

equipment for a patient

with difficult anatomy, with

supervision

Interprets point-of-care

ultrasound, with

supervision

Uses ultrasound for

vascular access in

complex situations, with

supervision

Independently selects

proper ultrasound

equipment and settings

for indicated scenarios

Independently conducts

and interprets point-of-

care ultrasound

Independently uses

ultrasound for vascular

access in complex

situations

Participates in research

of emerging ultrasound

procedures

Participates in the

development of

institutional protocols for

point-of-care ultrasound

Comments:

Not Yet Completed Level 1

Not Yet Assessable

Version 2 Anesthesiology, ACGME Report Worksheet

7

Patient Care 7: Situational Awareness and Crisis Management

Level 1 Level 2 Level 3 Level 4 Level 5

Demonstrates vigilance

during clinical care

Articulates causes of

common peri-operative

crisis situations

Responds to crisis

situations as a reliable

team member

Demonstrates awareness

of case flow and

developments throughout

a procedure

Recognizes crisis

situations; calls for help

Participates in

management during crisis

situations

Demonstrates awareness

of case flow and

developments throughout

a procedure, including

those outside of one’s

own immediate control,

with supervision

Anticipates impending

crisis and identifies

possible etiologies with

supervision

Initiates management and

resolves crisis situations,

with supervision

Independently

demonstrates

awareness of case flow

and developments

throughout a procedure,

including those outside

of one’s own immediate

control

Independently

anticipates impending

crisis and identifies

possible etiologies

Independently initiates

management and

resolves crisis situations

Leads the health care

team in the management

of crisis situations

Comments:

Not Yet Completed Level 1

Not Yet Assessable

Version 2 Anesthesiology, ACGME Report Worksheet

8

Patient Care 8: Post-Operative Care

Level 1 Level 2 Level 3 Level 4 Level 5

Outlines post-operative

disposition options for

patients

Lists complications

commonly encountered

post-operatively

Plans disposition for

uncomplicated

procedures

Diagnoses, manages, and

documents commonly

encountered

complications arising from

anesthetic care, with

supervision

Identifies unexpected

changes in patient status

meriting change in

disposition, with

supervision

Diagnoses, manages, and

documents uncommon

complications arising from

anesthetic care, with

supervision

Independently identifies

unexpected changes in

patient status meriting

change in disposition

Independently

diagnoses, manages,

and documents

uncommon

complications arising

from anesthetic care

Develops protocols for

disposition based on

procedure and patient

comorbidities

Comments:

Not Yet Completed Level 1

Not Yet Assessable

Version 2 Anesthesiology, ACGME Report Worksheet

9

Patient Care 9: Critical Care

Level 1 Level 2 Level 3 Level 4 Level 5

Acquires data for the

care of the critically-ill

patient

Recognizes when a

patient is critically ill

Interprets routine

diagnostic data in the

care of critically-ill

patients

Prioritizes the care of the

critically-ill patient

Implements the care

team’s plan for a critically-

ill patient

Interprets advanced

diagnostic data in the

care of critically-ill

patients, with supervision

Prioritizes the care of

multiple critically-ill

patients, with supervision

Develops and implements

a comprehensive plan of

care for the critically-ill

patient, with supervision

Independently interprets

advanced diagnostic

data in the care of

critically-ill patients

Independently

prioritizes the care of

multiple critically-ill

patients

Develops and

implements a

comprehensive plan of

care for the critically-ill

patient

Leads and deploys

resources in the care of

the critically-ill patient

Functions in a supervisory

role managing all patients

in a unit and the unit’s

resources

Comments:

Not Yet Completed Level 1

Not Yet Assessable

Version 2 Anesthesiology, ACGME Report Worksheet

10

Patient Care 10: Regional (Peripheral and Neuraxial) Anesthesia

Level 1 Level 2 Level 3 Level 4 Level 5

Describes anatomy

relevant to regional

anesthesia

Prepares the patient and

the equipment for

common regional

anesthesia techniques

Describes potential

complications of regional

anesthesia

Describes indications and

contraindications for

regional anesthesia

Performs regional

anesthesia techniques,

with direct supervision

Recognizes and manages

complications of regional

anesthesia, with direct

supervision

Develops a patient- and

procedure-specific

regional anesthesia plan,

with supervision

Performs regional

anesthesia techniques,

with indirect supervision

Recognizes and manages

complications of regional

anesthesia, with indirect

supervision

Independently develops

a patient- and

procedure-specific

regional anesthesia

plan

Independently performs

regional anesthesia

techniques

Independently

recognizes and

manages complications

of regional anesthesia

Serves as a consultant on

advanced or difficult

regional techniques

Develops institutional

protocol for using regional

anesthesia and managing

complications

Comments:

Not Yet Completed Level 1

Not Yet Assessable

Version 2 Anesthesiology, ACGME Report Worksheet

11

Medical Knowledge 1: Foundational Knowledge

Level 1 Level 2 Level 3 Level 4 Level 5

Demonstrates

knowledge of

pathophysiology and

treatment of medical and

surgical conditions

Identifies medications

used to treat common

comorbidities

Demonstrates knowledge

of common medical and

surgical disease,

treatments, and

populations as it relates to

anesthetic care

Demonstrates knowledge

of pharmacology of

medications routinely

used in anesthetic care

Demonstrates knowledge

of complex medical and

surgical disease,

treatments, and

populations as it relates to

anesthetic care

Demonstrates knowledge

of medications used in

subspecialty areas (e.g.,

cardiac, obstetrics)

Demonstrates

comprehensive

knowledge of medical

and surgical disease as

it relates to the full

spectrum of the

patient’s peri-operative

care

Demonstrates

comprehensive

knowledge of

pharmacology in the

setting of complex

comorbidities

Demonstrates scientific

knowledge of uncommon,

atypical, or complex

conditions as it relates to

the full spectrum of the

patient’s peri-operative

care

Participates in research

related to pharmacology

Comments:

Not Yet Completed Level 1

Not Yet Assessable

Version 2 Anesthesiology, ACGME Report Worksheet

12

Medical Knowledge 2: Clinical Reasoning

Level 1 Level 2 Level 3 Level 4 Level 5

Organizes and

accurately summarizes

information obtained

from the patient

evaluation to develop a

clinical impression

Lists types of clinical

reasoning errors

Integrates information

from all sources to

develop a basic

differential diagnosis for

common patient

presentations

Identifies clinical

reasoning errors within

patient care, with

guidance

Develops a thorough and

prioritized differential

diagnosis for common

patient presentations

Retrospectively applies

clinical reasoning

principles to identify

errors

Develops prioritized

differential diagnoses in

complex patient

presentations and

incorporates subtle,

unusual, or conflicting

findings

Continually re-appraises

one’s clinical reasoning

to improve patient care

in real time

Coaches others to

develop prioritized

differential diagnoses in

complex patient

presentations

Models how to recognize

errors and reflect upon

one’s own clinical

reasoning

Comments:

Not Yet Completed Level 1

Not Yet Assessable

Version 2 Anesthesiology, ACGME Report Worksheet

13

Systems-Based Practice 1: Patient Safety and Quality Improvement

Level 1 Level 2 Level 3 Level 4 Level 5

Demonstrates

knowledge of common

events that impact

patient safety

Demonstrates

knowledge of how to

report patient safety

events

Demonstrates

knowledge of basic

quality improvement

methodologies and

metrics

Identifies system factors

that lead to patient safety

events

Reports patient safety

events through

institutional reporting

systems (simulated or

actual)

Describes departmental

quality improvement

initiatives

Participates in analysis of

patient safety events

(simulated or actual)

Participates in disclosure

of patient safety events to

patients and families

(simulated or actual)

Participates in department

quality improvement

initiatives

Conducts analysis of

patient safety events

and offers error

prevention strategies

(simulated or actual)

Discloses patient safety

events to patients and

families (simulated or

actual)

Demonstrates the skills

required to identify,

develop, implement,

and analyze a quality

improvement project

Actively engages teams

and processes to modify

systems to prevent

patient safety events

Role models or mentors

others in the disclosure of

patient safety events

Creates, implements, and

assesses quality

improvement initiatives at

the institutional level or

above

Comments:

Not Yet Completed Level 1

Version 2 Anesthesiology, ACGME Report Worksheet

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Systems-Based Practice 2: System Navigation for Patient-Centered Care

Level 1 Level 2 Level 3 Level 4 Level 5

Demonstrates

knowledge of care

coordination

Identifies key elements

for safe and effective

transitions of care and

hand-offs

Demonstrates

knowledge of population

and community health

needs and disparities

Coordinates care of

patients in routine clinical

situations effectively using

the roles of the

interprofessional team

members

Performs safe and

effective transitions of

care/hand-offs in routine

clinical situations

Identifies specific

population and

community health needs

and inequities for their

local population

Coordinates care of

patients in complex

clinical situations

effectively using the roles

of the interprofessional

team members

Performs safe and

effective transitions of

care/hand-offs in complex

clinical situations

Uses institutional

resources effectively to

meet the needs of a

patient population and

community

Role models effective

coordination of patient-

centered care among

different disciplines and

specialties

Role models and

advocates for safe and

effective transitions of

care/hand-offs within

and across health care

delivery systems

Participates in changing

and adapting practice to

provide for the needs of

specific populations

Analyzes the process of

care coordination and

participates in the design

and implementation of

improvements

Improves quality of

transitions of care within

and across health care

delivery systems to

optimize patient outcomes

Advocates for populations

and communities with

health care inequities in

the peri-operative setting

Comments:

Not Yet Completed Level 1

Version 2 Anesthesiology, ACGME Report Worksheet

15

Systems-Based Practice 3: Physician Role in Health Care Systems

Level 1 Level 2 Level 3 Level 4 Level 5

Identifies key

components of the

complex health care

system (e.g., hospital,

skilled nursing facility,

finance, personnel,

technology)

States factors impacting

the costs of anesthetic

care

Describes how

components of a complex

health care system are

interrelated, and how this

impacts patient care

Documents anesthetic

detail to facilitate accurate

billing and reimbursement

Discusses how individual

practice affects the

broader system (e.g.,

length of stay,

readmission rates, clinical

efficiency)

Explains the impact of

documentation on billing

and reimbursement

Manages various

components of the

complex health care

system to provide

efficient and effective

patient care and

transition of care

Practices and

advocates for cost-

effective patient care

Advocates for or leads

systems change that

enhances high-value,

efficient, and effective

patient care

Engages in external

activities related to

advocacy for cost-

effective care

Comments:

Not Yet Completed Level 1

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16

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

Level 1 Level 2 Level 3 Level 4 Level 5

Accesses and uses

evidence in routine

patient care

Articulates clinical

questions and elicits

patient preferences and

values to guide evidence-

based care

Locates and applies the

best available evidence,

integrated with patient

preference, to the care of

complex patients

Appraises and applies

evidence, even in the

face of uncertainty and

conflicting evidence, to

guide individualized

care

Coaches others to

appraise and apply

evidence for complex

patients and/or

participates in the

development of guidelines

Comments:

Not Yet Completed Level 1

Version 2 Anesthesiology, ACGME Report Worksheet

17

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

personal and

professional

development by

establishing goals

Identifies the factors that

contribute to

performance deficits

Actively seeks

opportunities to improve

Demonstrates openness

to performance data

(feedback and other

input) to form goals

Analyzes and

acknowledges the factors

that contribute to

performance deficits

Designs and implements

a learning plan, with

prompting

Seeks performance data

episodically, with

adaptability and humility

Institutes behavioral

change(s) to improve

performance

Independently creates

and implements a

learning plan

Intentionally seeks

performance data

consistently, with

adaptability and humility

Considers alternatives

to improve performance

Integrates performance

data to adapt the

learning plan

Role models consistently

seeking performance

data, with adaptability and

humility

Models reflective practice

Facilitates the design and

implementation of

learning plans for others

Comments:

Not Yet Completed Level 1

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18

Professionalism 1: Professional Behavior and Ethical Principles

Level 1 Level 2 Level 3 Level 4 Level 5

Identifies potential

triggers for

professionalism lapses

Describes when and how

to report lapses in

professionalism

Demonstrates

knowledge of the ethical

principles underlying

patient care

Demonstrates insight into

professional behavior in

routine situations

Takes responsibility for

one’s own

professionalism lapses

Analyzes straightforward

situations using ethical

principles

Demonstrates

professional behavior in

complex or stressful

situations

Recognizes need to seek

help in managing and

resolving complex

interpersonal situations

Analyzes complex

situations using ethical

principles

Recognizes situations

that may trigger

professionalism lapses

and intervenes to

prevent lapses in

oneself

Actively solicits help

and acts on

recommendations to

resolve complex

interpersonal situations

Recognizes and utilizes

resources for managing

and resolving ethical

dilemmas

Coaches others when

their behavior fails to

meet professional

expectations

Identifies and seeks to

address system-level

factors that induce or

exacerbate ethical

problems or impede their

resolution

Comments:

Not Yet Completed Level 1

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19

Professionalism 2: Accountability/Conscientiousness

Level 1 Level 2 Level 3 Level 4 Level 5

Responds promptly to

requests or reminders to

complete tasks

Takes responsibility for

failure to complete tasks

Performs tasks and

responsibilities in a timely

manner

Recognizes situations

that may impact one’s

own ability to complete

tasks and responsibilities

in a timely manner

Performs tasks and

responsibilities in a timely

manner with appropriate

attention to detail in

routine situations

Takes responsibility for

tasks not completed in a

timely manner and

identifies strategies to

prevent recurrence

Prioritizes tasks and

responsibilities in a

timely manner with

appropriate attention to

detail in complex or

stressful situations

Proactively implements

strategies to ensure that

the needs of patients,

teams, and systems are

met

Designs and implements

an institutional systems

approach to ensure timely

task completion and

shared responsibility

Comments:

Not Yet Completed Level 1

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Professionalism 3: Well-Being

Level 1 Level 2 Level 3 Level 4 Level 5

Recognizes the

importance of

addressing personal and

professional well-being

Lists available resources

for personal and

professional well-being

Describes institutional

resources that are meant

to promote well-being

With assistance,

proposes a plan to

promote personal and

professional well-being

Recognizes which

institutional factors affect

well-being

Independently develops

a plan to promote

personal and

professional well-being

Describes institutional

factors that positively

and/or negatively affect

well-being

Creates institutional-level

interventions that promote

colleagues’ well-being

Describes institutional

programs designed to

examine systemic

contributors to burnout

Comments:

This subcompetency is not intended to evaluate a resident’s well-being. Rather, the intent is to ensure that each resident has the fundamental knowledge of factors

that affect well-being, the mechanisms by which those factors affect well-being, and available resources and tools to improve well-being.

Not Yet Completed Level 1

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21

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

Level 1 Level 2 Level 3 Level 4 Level 5

Communicates with

patients and their

families in an

understandable and

respectful manner

Provides timely updates

to patients and patients’

families

Customizes

communication in the

setting of personal biases

and barriers with patients

and patients’ families

Actively listens to patients

and patients’ families to

elicit patient preferences

and expectations

Explains complex and

difficult information to

patients and patients’

families

Uses shared decision

making to make a

personalized care plan

Facilitates difficult

discussions with

patients and patients’

families

Effectively negotiates

and manages conflict

among patients,

patients’ families, and

the health care team

Mentors others in the

facilitation of crucial

conversations

Mentors others in conflict

resolution

Comments:

Not Yet Completed Level 1

Version 2 Anesthesiology, ACGME Report Worksheet

22

Interpersonal and Communication Skills 2: Interprofessional and Team Communication

Level 1 Level 2 Level 3 Level 4 Level 5

Respectfully requests or

receives consultations

Uses language that

values all members of

the health care team

Respectfully receives

feedback from the health

care team

Clearly, concisely and

promptly requests or

responds to a

consultation

Communicates

information effectively

with all health care team

members

Solicits feedback on

performance as a

member of the health

care team

Uses closed-loop

communication to verify

understanding

Adapts communication

style to fit team needs

Communicates concerns

and provides feedback to

peers and learners

Coordinates

recommendations from

different members of

the health care team to

optimize patient care

Maintains effective

communication in crisis

situations

Communicates

constructive feedback to

superiors

Role models flexible

communication strategies

that value input from all

health care team

members, resolving

conflict when needed

Leads an after-event

debrief of the health care

team

Facilitates regular health

care team-based

feedback in complex

situations

Comments:

Not Yet Completed Level 1

Version 2 Anesthesiology, ACGME Report Worksheet

23

Interpersonal and Communication Skills 3: Communication within Health Care Systems

Level 1 Level 2 Level 3 Level 4 Level 5

Accurately records

information in the patient

record; demonstrates

judicious use of

documentation shortcuts

Safeguards patient

personal health

information

Communicates through

appropriate channels as

required by institutional

policy

Accurately records

information in the

anesthetic record for

basic cases

Documents required data

in formats specified by

institutional policy

Respectfully

communicates concerns

about the system

Accurately records

information in the

anesthetic record and

communicates complex

care decisions for

complex cases

Appropriately selects

direct and indirect forms

of communication based

on context

Respectfully

communicates concerns

about the system and

contributes to solutions

Uses medical record

functionality to highlight

challenges in anesthetic

care to facilitate future

peri-operative

management

Models exemplary

written or verbal

communication

Uses appropriate

channels to offer clear

and constructive

suggestions to improve

the system

Explores innovative uses

of the medical record to

facilitate peri-operative

management

Guides departmental or

institutional policies and

procedures around

communication

Initiates difficult

conversations with

appropriate stakeholders

to improve the system

Comments:

Not Yet Completed Level 1