Introduction: Feedback, particularly real-time feedback, is critical to resident education.  The emergency medicine (EM) milestones were developed in 2012 to enhance resident assessment and many programs utilize them to provide focused resident feedback. The purpose of this study was to evaluate EM residents’ level of interest in receiving real-time feedback on each of the 23 milestone sub-competencies.

Methods: This was a multicenter cross sectional study of EM residents. Participants were surveyed on their level of interest in receiving real-time on-shift feedback on each of the 23 milestone sub-competencies. Anonymous paper or computerized surveys were distributed to residents at three 4-year training programs and three 3-year training programs with a total of 223 resident respondents. Residents rated their level of interest in each milestone on a 6-point semantic differential response scale. Average level of interest was calculated for each of the 23 sub-competencies, both as an average of all 223 respondents as well as by individual postgraduate year (PGY) level of training. One-way ANOVA analysis was performed to determine statistical significance.

Results: The overall survey response rate across all institutions was 82%. Emergency stabilization had the highest mean rating (5.47/6) while technology had the lowest rating (3.24/6). However, none of the 23 milestone sub-competencies were statistically significant based on ANOVA analysis.

Conclusion: It is unclear whether residents ascribe much more value to certain sub-competency domains than others.  Further studies are necessary to determine whether residents’ sub-competency valuations need to be considered when developing an assessment or feedback program focusing on the 23 EM milestones.