What it does
Milestone tracking shows where every learner stands on the program's competency framework, using a five-level scale. Staff who can manage program settings record new levels directly from the page, and competency reviews capture individual assessments with performance levels and feedback, rolling up into reports, matrices, and trend views.
Who it's for
Program directors and administrators review the program-wide picture and prepare committee materials. Staff who can manage program settings record a level from this page; faculty supervisors contribute assessments through evaluation forms mapped to the same framework. Learners see feedback that reviewers mark visible to them.
How it works
The tracking page. The Milestones page (Learner Outcomes → Milestones) has two tabs: By Learner (a matrix of each learner's level across milestones) and By Milestone (milestones grouped under parent competencies). There is no radar chart on this page — the cohort radar lives on Competencies → Shape instead, and a View cohort shape link on this page opens Competencies (/competencies) to get there. Viewing the page needs gradebook view permission. Older skills and competencies links, and Gradebook's own /grades/milestones address, redirect here; Gradebook's sidebar no longer lists Milestones.
The five-level scale. Assessment levels run from 1 to 5: Critical Deficiencies, Early Learner, Advancing, Ready for Unsupervised Practice, and Aspirational. The Record a level button opens the Record a milestone level sheet, which saves a 1–5 level with notes for a learner on a specific milestone. Recording a level needs program-settings permission — gradebook grading or editing permission is not enough.
Competency reviews. A review records the reviewer, date, performance level, feedback to the learner, and internal notes, tied to a subcompetency in the program's framework. Reviews can be filtered by learner, subcompetency, date range, and text. Summary statistics show coverage across subcompetencies, average performance level, and peer comparison.
Learner Outcomes reports. On /competencies, staff switch among Compare cohort (matrix), Inspect learner (tree), table, and Shape views. Who defaults to All learners and When defaults to All time, so Compare cohort works without picking a person. By role narrows the cohort. One trainee reveals the person picker and is required for Inspect learner and table. Opening either without a person switches Who for you and focuses the picker. Selecting a trainee while Compare cohort is open adds a note that the matrix still shows the cohort.
Shape. This view follows Who. It draws a cohort mean radar for All learners or By role (hidden under five scored learners), or learner-versus-peers for One trainee (needs at least five peers). It adds a plain-language gap insight and a month scrubber keyed to assessment dates, not CCC meeting cycles. View cohort shape resets Who to All learners. Axis chips and Jump to evidence open the individual tree for drill-down; Open in profile links to the person's Education tab.
Expected-level thresholds. Program and institution admins set the expected competency level over time from Learner Outcomes → Thresholds. Skills are grouped by competency. Each band has a start month and end month since program start, plus an expected level on the same 1–5 scale. Add or edit bands on one skill. You can also apply one band to every skill in a competency at once (overlapping bands on a skill are skipped), or load ACGME default year bands onto skills that still have none. Choosing a level shows that skill's milestone wording from the framework, when one exists. These program-wide defaults power expected-versus-actual views; they are not configured in program settings.
Reports and trends. Competency reports also support PDF export, heatmap and comparison views, and longitudinal trend tracking across periods.
Before you start
You need gradebook view permission to view the page; recording a level needs program-settings permission (program-management or institution-management), not gradebook grading or editing permission. Learners cannot browse other learners' assessments.
The learner's academic period must not already be finalized — finalizing through the committee workflow freezes that period's assessment rows against edits.
Setting expected-level thresholds needs program-management or institution-management permission, and a program selected on the Thresholds screen.
Do this
Open the Milestones page (
/competencies/milestones) → you should see the By Learner and By Milestone tabs.If you can manage program settings, select Record a level → the Record a milestone level sheet opens with Learner, Milestone, and Level fields.
Choose the Learner and Milestone in the sheet, then set the Level on the 1–5 scale → the level names (Critical Deficiencies through Aspirational) show as you select.
Add any notes, then select Save level → you should return to the Milestones page and see the new level reflected on the By Learner matrix.
You're done when
The learner's row on the By Learner matrix shows the new level for that milestone.
Opening View cohort shape (Competencies → Shape) and any other Learner Outcomes views for that learner reflect the updated assessment.
Boundaries and limits
The milestone structure comes from the competency framework configured for the program. This page displays and assesses against that framework; it does not define its own.
Assessment levels are the fixed 1–5 scale described above. There are no custom scales on this page.
This page has two tabs, By Learner and By Milestone. The competency radar is Shape on Competencies, not a tab here.
Recording a level from this page requires program-settings permission. Faculty who only have gradebook view or grading permission contribute through evaluation forms mapped to the framework, not through Record a level.
Feedback on a review reaches the learner only when the reviewer marks it learner-visible; internal notes stay with staff.
Access to the page follows gradebook view permission; recording a level follows program-settings permission. Learners do not browse other learners' assessments.
Once a learner's academic period is finalized through the committee workflow, its assessment rows are frozen against edits. A formal reopen action is needed to edit them again.
Shape peer overlays stay hidden when fewer than five peers have assessments. This keeps the chart from drawing a false "at peer mean" polygon.
Cohort shape stays hidden when fewer than five learners have scores under the current evidence filters.
Shape months (learner mode) are calendar months of assessment evidence, not academic-period or CCC cycle labels. Use When to bound evidence for cohort and learner Shape alike.
Shape uses the same Forms / Rotations / Graded Course Rotations evidence filters as Compare cohort. Cohort Shape can optionally show the spread (p25–p75) of learner means. Evidence defaults to mapped forms and reviews, set under Report settings → Assessment source.
Shape shows up to eight core competencies on the radar. Cohort shape is one mean polygon, not a multi-learner overlay of the full cohort matrix.
Expected-level thresholds require program-management or institution-management permission, and apply to the currently selected program. Without a program selected, the Thresholds screen asks you to choose one first.
Applying a band to a competency copies it onto each subcompetency in that group. It does not attach a schedule to the parent competency, and it skips a skill that already has an overlapping band. Group apply is unavailable while a search filter is active.
Common questions
Q: I used to open this from Gradebook. Where did it go? A: Open Learner Outcomes, then Milestones (/competencies/milestones). The old Gradebook address (/grades/milestones) still redirects here; Gradebook's sidebar no longer lists it.
Q: Why don't I see Record a level? A: Recording a level requires program-settings permission, not gradebook grading or editing permission. Faculty still contribute through evaluation forms mapped to the framework.
Q: Where do the milestone levels come from? A: From assessments recorded by faculty and staff — either with Record a level on this page or through evaluation workflows that feed the same framework.
Q: Can learners see their milestone feedback? A: They see feedback that the reviewer marked visible to them. Internal reviewer notes are never shown to learners.
Q: Can we edit an assessment after the committee signs off on the period? A: No — finalizing a period freezes its assessments. A permitted administrator must reopen the period first, which is itself a controlled, logged action.
Q: Where do we set expected competency levels for trainees? A: Open Learner Outcomes, then Thresholds. Choose a program first if one is not already selected. Bookmarks to the old program-settings URL still open this page. You can set a band on one skill or apply the same band to every skill in a competency.
Q: What is the Shape view on Learner Outcomes? A: Set Who to All learners (or By role) and open Shape to see the cohort mean competency shape under the current evidence and When filters. Set Who to One trainee — or open a learner from Compare cohort — to see that learner versus peers, then scrub month by month. Use View cohort shape to return Who to All learners, Jump to evidence for the tree of responses, or Open in profile for the person record.
GME programs
Applies to: gme. Differences from the base article only.
Who it's for
In GME programs, the learners are residents and fellows. Attendings and program leaders do the assessing. The Clinical Competency Committee (CCC) is the main user of the rolled-up picture. Program coordinators usually keep the data current. The program director presents the matrix at CCC meetings.
How it works
The framework maps onto the milestone structure residency programs already use. Competencies have subcompetencies underneath. Each is assessed on the five-level scale. Level 4 is "Ready for Unsupervised Practice." Most programs treat it as the graduation target. Level 5, "Aspirational," is beyond expected performance.
End-of-rotation forms carry milestone-style questions. These feed the same framework, so attending evaluations flow into the by-learner matrix without separate data entry. Use the by-learner matrix on Milestones and the radar on Competencies → Shape to prepare for CCC — they serve directly as prep material, but they're on separate pages. The committee dashboard uses these assessments for its twice-yearly reviews and period sign-off.
Common questions
Q: Does finalizing at the CCC meeting lock the resident's milestone record? A: Yes. Finalizing the academic period freezes the rows the committee reviewed. Late evaluations show as a pending count, and the period must be formally reopened to add them.
Q: Do residents see their milestone levels? A: Residents see the feedback reviewers marked visible to them. Committee deliberation notes stay internal to the program.
Related articles