Efficiently exploring the causal role of contextual moderators in behavioral science.

Behavioral science interventions have the potential to address longstanding policy problems, but their effects are typically heterogeneous across contexts (e.g., teachers, schools, and geographic regions). This contextual heterogeneity is poorly understood, however, which reduces the field's impact and its understanding of mechanisms. Here, we present an efficient way to interrogate heterogeneity and address these gaps in knowledge. This method a) presents scenarios that vividly represent different moderating contexts, b) measures a short-term behavioral outcome (e.g., an academic choice) that is known to relate to typical intervention outcomes (e.g., academic achievement), and c) assesses the causal effect of the moderating context on the link between the psychological variable typically targeted by interventions and this short-term outcome. We illustrated the utility of this approach across four experiments (total n = 3,235) that directly tested contextual moderators of the links between growth mindset, which is the belief that ability can be developed, and students' academic choices. The present results showed that teachers' growth mindset-supportive messages and the structural opportunities they provide moderated the link between students' mindsets and their choices (studies 1 to 3). This pattern was replicated in a nationally representative sample of adolescents and did not vary across demographic subgroups (study 2), nor was this pattern the result of several possible confounds (studies 3 to 4). Discussion centers on how this method of interrogating contextual heterogeneity can be applied to other behavioral science interventions and broaden their impact in other policy domains.

A values-aligned intervention fosters growth mindset-supportive teaching and reduces inequality in educational outcomes.

Group-based educational disparities are smaller in classrooms where teachers express a belief that students can improve their abilities. However, a scalable method for motivating teachers to adopt such growth mindset-supportive teaching practices has remained elusive. In part, this is because teachers often already face overwhelming demands on their time and attention and have reason to be skeptical of the professional development advice they receive from researchers and other experts. We designed an intervention that overcame these obstacles and successfully motivated high-school teachers to adopt specific practices that support students' growth mindsets. The intervention used the values-alignment approach. This approach motivates behavioral change by framing a desired behavior as aligned with a core value-one that is an important criterion for status and admiration in the relevant social reference group. First, using qualitative interviews and a nationally representative survey of teachers, we identified a relevant core value: inspiring students' enthusiastic engagement with learning. Next, we designed a ~45-min, self-administered, online intervention that persuaded teachers to view growth mindset-supportive practices as a way to foster such student engagement and thus live up to that value. We randomly assigned 155 teachers (5,393 students) to receive the intervention and 164 teachers (6,167 students) to receive a control module. The growth mindset-supportive teaching intervention successfully promoted teachers' adoption of the suggested practices, overcoming major barriers to changing teachers' classroom practices that other scalable approaches have failed to surmount. The intervention also substantially improved student achievement in socioeconomically disadvantaged classes, reducing inequality in educational outcomes.

Creative mindset reduces racial ingroup bias in empathic neural responses.

Spontaneous racial categorization of other-race individuals provides a cognitive basis of racial ingroup biases in empathy and prosocial behavior. In two experiments, we investigated whether fostering a creativity mindset reduces racial ingroup biases in empathy and undermines spontaneous racial categorization of other-race faces. Before and after a creative mindset priming procedure that required the construction of novel objects using discreteness, we recorded electroencephalography signals to Asian and White faces with painful or neutral expressions from Chinese adults to assess neural activities underlying racial ingroup biases in empathy and spontaneous racial categorization of faces. We found that a frontal-central positive activity within 200 ms after face onset (P2) showed greater amplitudes to painful (vs. neutral) expressions of Asian compared with White faces and exhibited repetition suppression in response to White faces. These effects, however, were significantly reduced by creative mindset priming. Moreover, the creative mindset priming enhanced the P2 amplitudes to others' pain to a larger degree in participants who created more novel objects. The priming effects were not observed in control participants who copied objects constructed by others. Our findings suggest that creative mindsets may reduce racial ingroup biases in empathic neural responses by undermining spontaneous racial categorization of faces.

How a defensive mindset develops from early adverse experiences and guides antisocial outcomes.

Dante Cicchetti has had a lasting impact on our understanding of the development of externalizing psychopathology through at least two seminal contributions, including establishment of the field of developmental psychopathology and assertion of the hypothesis that early physical abuse and neglect trigger a cascade of maladaptive outcomes across the life course. These ideas have guided a program of research on children's deviant social information processing and defensive mindset as the psychological mechanisms through which early physical abuse leads to long-term psychopathology. Longitudinal studies following children from early life through mid-adulthood show that physical abuse in the first five years of life leads children to adopt a defensive mindset that, in turn, cascades into long-term outcomes of externalizing psychopathology, incarceration, and dysfunction. Cicchetti's ideas have also guided the development of preventive interventions to interrupt this life course.

Stunted upward mobility in a learning environment reduces the academic benefits of growth mindsets.

Does stunted upward mobility in an educational system impede beneficial psychological processes of learning? We predicted that growth mindsets of intelligence, a well-established psychological stimulant to learning, would be less potent in low-mobility, as compared to high-mobility, learning environments. An analysis of a large cross-national dataset and a longitudinal experiment accumulated converging evidence for this hypothesis. Study 1 examined data from 15-y-old students across 30 countries (n = 235,141 persons). Replicating past findings, growth mindsets positively predicted students' math, science, and reading literacy. More importantly, the country-level indicator of educational mobility (i.e., the percentage of children from low-education households to graduate from tertiary education) moderated the effect of growth mindsets. Depending on the subject, the gain in predicted academic performance from a one-unit increase in growth mindsets was reduced by 42 to 45% from a high-mobility to a low-mobility country. Results were robust with or without important covariates. Study 2 experimentally manipulated people's perception of mobility in a carefully constructed learning environment. The moderating role of educational mobility was replicated and extended to learning behavior, which subsequently predicted performance. Evidence further suggests that in high-mobility environments, both advantaged and disadvantaged learners benefited from growth mindsets, albeit likely through diverging mechanisms; when the effect of growth mindsets was attenuated in low-mobility environments, the potential for the disadvantaged to overcome the performance gap was also limited. Implications for galvanizing the upward mobility of the disadvantaged, evaluating the effectiveness of mindset interventions, and conceptualizing social mobility from a psychological perspective are discussed.

The role of implicit theories of intelligence and personality in older adults' resilience: cognitive functioning and social participation as two mediators.

OBJECTIVES: Resilience during old age reflects the capacity to adapt to changes and challenges associated with normative aging and is an important component of successful aging. Belief in the incremental theory of intelligence and personality could help older adults maintain cognitive functioning and social engagement, which may further contribute to their resilience. The current study investigated how implicit theories of intelligence and personality affected older adults' resilience and examined cognitive functioning and social participation as two mediators. METHOD: A total of 108 older adults aged 60-92 were recruited and completed relevant scales and cognitive tasks. Path analyses were conducted to estimate the expected mediation model. RESULTS: The incremental theory of intelligence, but not personality, was positively related to older adults' resilience. Both cognitive functioning and social participation mediated the effect of the implicit theory of intelligence in the model without covariates. When background variables were controlled, the mediation effect of cognitive functioning remained significant, while the link between the implicit theory of intelligence and social participation was weakened. CONCLUSION: Older adults' implicit theory of intelligence plays a significant role in fostering resilience in late adulthood, especially through maintaining older adults' cognitive functioning.

Combined Exercise and Mindset Training During a Pediatric Cardiac Fitness and Rehabilitation Program Benefits Youth with a Range of Congenital Heart Disease.

Pediatric cardiac fitness and rehabilitation programs vary widely in structure and content. The Cardiac Fitness Program (CFP) is built on traditional training pillars of aerobic, strength, and flexibility, and adds a fourth, training a positive mindset. This study assesses whether the systematic and comprehensive framework of the CFP results in broad benefits for a range of patients with congenital heart disease (CHD). Data from participants between 01/2017 and 12/2022 were analyzed. Pre- and post-CFP cardiopulmonary exercise test parameters, strength and flexibility metrics, and mindset survey results were compared overall, and by sex, age, diagnosis, and hemodynamic level. Of 62 participants (median age 15.5 years, range 8 to 23, 50% female), 3% had simple, 37% complex, 24% single ventricle CHD, and 35% arrhythmia, cardiomyopathy, or transplant. Significant improvements were noted in aerobic fitness (mean 9 ± 15% increase in % predicted peak oxygen consumption, p < 0.001). Strength metrics significantly improved (each p < 0.001), as did flexibility (p < 0.001). Patient-reported positive mindset scores did not improve significantly (mean increase 1.8 ± 5.1, p = 0.10, n = 25), whereas parents reported significant improvements (5.9 ± 10.4, p = 0.02, n = 20). Improvements were not significantly different by sex, age, diagnosis, or hemodynamic level. Comprehensive training across four pillars of fitness yields significant improvements in aerobic fitness, strength, flexibility, and parent-reported mindset scores for pediatric CHD patients, regardless of patient characteristics, diagnosis type, or severity of hemodynamic limitation. Further study is warranted into optimal standardization of training and whether a comprehensive approach amplifies individual pillars to create more than the sum of its parts.

"Broken fragments or a breathtaking mosaic": A mixed methods study of self-reported attributes and aspirations of siblings of individuals with and without neurodevelopmental conditions.

Siblings of individuals with neurodevelopmental conditions (NDCs) experience distinct challenges and have unique strengths compared to siblings of individuals without NDCs. The present study examined attributes and aspirations of siblings of individuals with and without neurodevelopmental conditions, and analyzed the association between qualitative responses and quantitative measures of growth mindset, positive and negative valence, and mental health diagnoses. A novel mixed methods thematic analysis was employed to explore the experiences of 166 siblings (75 NDC and 91 controls, aged 14-26, 66.27% female) completing an online survey as part of a larger study on sibling mental health. The overarching theme described The Process of Self-Actualization and Integration, reflecting the journey siblings undergo in seeking to understand themselves and others amidst psychological challenges. It encompassed three subthemes: Personal Growth and Identity Formation; Connection and Belonginess; and Societal Perspective and Global Consciousness. Qualitative responses were analyzed within a Research Domain Criteria (RDoC) framework, and associations between phenomenology and mental health diagnoses examined. NDC siblings had higher negative valence and lower positive valence embedded in their responses, and quantitatively lower self-reported growth mindset (i.e., beliefs about the capacity for personal growth), compared to control siblings, which correlated with self-reported mental health diagnoses. Findings suggest clinical practice may focus on optimizing self-identified strengths and offer opportunities for self-actualization of hopes and ambitions, while providing support for families to attenuate bioecological factors impacting mental health.

Physical cleansing reduces the mindset effect in problem-solving.

The present study investigated whether physical cleansing can reduce the mindset effect in problem-solving in two experiments. Both experiments followed the same procedure. In the first stage, participants formed a mindset through the Luchins' water-jar task (Experiment 1) or the idiom maze task (Experiment 2). The second stage is cleansing manipulation. In Experiment 1, participants were asked to clean their hands with wipes (cleansing condition) or examine the packaging of the wipes (no-cleansing condition). In Experiment 2, participants were asked to watch a washing-hands video (cleansing condition) or watch an examining-pen video (no-cleansing condition). At last, all participants completed the mindset effect test problems. The results showed that the participants in the cleansing condition were less affected by the mindset than those in the no-cleansing condition, indicating that physical cleansing reduced the mindset effect. Our results provide new evidence for the clean-slate effects and support the hypothesis that physical cleansing is an embodied process of psychological separation.

The Moderating Role of Stress Mindset on the Relationship between Drinking to Cope and Alcohol Consumption among Undergraduate College Student Drinkers.

OBJECTIVE: Previous research suggests drinking alcohol to cope with negative affect, including stress, is a risk for increased alcohol consumption and alcohol-related problems. Stress mindset, the individually held belief that stress can lead to either enhancing or debilitating outcomes, has yet to be studied within the context of alcohol use. Studying stress mindset among college students as it relates to alcohol consumption may provide important insight into heavy alcohol use in this population. METHOD: A sample of 320 undergraduates (Mage = 19.06 (SD = 0.06); 63.44% female; 65.49% White) who endorsed past-year alcohol use completed self-report measures of drinking motives, stress mindset, alcohol consumption, and alcohol-related consequences. Zero-inflated negative binomial regressions were utilized to examine the moderating effect of stress mindset on the relationship between drinking to cope and alcohol consumption. RESULTS: Stress mindset significantly moderated the relationship between drinking to cope and alcohol consumption (IRR = 0.98, se = 0.01, p < 0.05, CI = 0.96, 1.00), such that the relationship was stronger among those with a debilitating stress mindset compared to those with an enhancing stress mindset. Stress mindset did not significantly moderate the relationship between drinking to cope and alcohol-related consequences. CONCLUSIONS: Individuals with high drinking to cope scores and who hold a debilitating stress mindset may be at a particular vulnerability for heavy alcohol consumption. The present study furthers our understanding of predictors of alcohol use in a college sample and suggests the importance of future research focused on stress mindset among college student drinkers.

Predictors and Mechanisms of Resilience for High School Students with ADHD: A Prospective Longitudinal Study.

Attention-deficit/hyperactivity disorder (ADHD) has primarily been studied from a deficit-focused perspective. However, there are individuals with ADHD who exhibit resilience or a pattern of positive adaptation despite the risks associated with their diagnosis. The present study evaluated whether peer acceptance predicted resilience for adolescents with ADHD and if self-efficacy or a stress-is-enhancing mindset served as mechanisms of those relations. Participants included 113 comprehensively evaluated adolescents with ADHD (67% male) across three time-points (10th-12th grade). Mediation analyses revealed higher T1 peer acceptance significantly predicted higher resilience (ß = 0.24) 1.5-2 years later, with higher T2 self-efficacy (ß = 0.08) demonstrating a significant indirect effect of the association. A stress-is-enhancing mindset directly predicted resilience (ß = 0.15) but was not associated with peer acceptance nor mediated the association between peer acceptance and resilience. Present results are the first to provide longitudinal evidence for peer acceptance, self-efficacy, and a stress-is-enhancing mindset as important for promoting resilience among adolescents with ADHD.

Seeing is believing: The effect of subtle communication in social media on viewers' beliefs about depression and anxiety symptom trajectories.

OBJECTIVE: One barrier to treatment seeking, uptake, and engagement is the belief that nothing can be done to reduce symptoms. Given the widespread use of social media to disseminate information about important issues, including psychological health, we sought to understand how the influence of social media communication regarding mental health impacts viewers' beliefs about psychopathology recovery. METHOD: Undergraduate participants from a large Midwestern university (N = 322) were randomized to view a series of Tweets characterizing psychopathology from a fixed mindset perspective, a growth mindset perspective, or, in the control condition, Tweets unrelated to psychopathology. Afterward, they completed a series of questionnaires designed to assess beliefs about recovery from depression and anxiety. RESULTS: Participants in the growth mindset condition endorsed less pessimistic beliefs about their ability (i.e., self-efficacy) to alleviate symptoms of depression and anxiety, and they believed these symptoms to be less stable and innate relative to those in the fixed mindset condition. CONCLUSION: Social media communication that characterizes psychopathology from a growth mindset perspective may be a viable intervention for improving beliefs around mental health self-efficacy and the malleable nature of mental illness, particularly depression and anxiety. Clinicians may be able to use social media platforms to promote functional beliefs around mental illness.

Finding Joy in Science.

This piece discusses the importance of sustainable education within the framework of the UN's 2030 Agenda for Sustainable Development. We emphasize the need to foster a lifelong love for learning by instilling curiosity, emotional bonds, and joy in students. We suggest simplifying teaching methods to maximize depth of understanding, integrating wonder and emotion into scientific education, promoting vertical exploration rather than just covering knowledge horizontally, and fostering resilience and independence through experiential learning. We also advocate for collaborative learning environments and incorporating real-world projects into education. Ultimately, the goal is to create spaces where students can explore, experience joy, and develop a lasting passion for learning.

Improving interprofessional teamwork in a community mental health team: a team building circle program based on the restorative justice paradigm.

Improving teamwork among mental health practitioners is crucial. However, there have been few intervention studies on teamwork enhancement among community mental health practitioners in South Korea. We aimed to determine the effectiveness of the Team Building Circle program (TBC) based on the restorative justice paradigm, which sought to promote integration and cohesion. The TBC was developed to improve conflict interpretation mind-set, interpersonal skills, and teamwork among practitioners in community mental health centers. We conducted a quasi-experimental study using a pre and posttest design with a non-equivalent control group. The participants were 44 practitioners from four community mental health centers. Data were collected before the implementation TBC (pretest), just after (posttest), and 3 months after TBC (follow-up test). A generalized estimating equation model was used for analysis. Our findings indicate that the intervention group had improved scores in the ability to cope with interpersonal stress in a constructive way, interpersonal relationship skills, and teamwork compared to the control group. To improve teamwork among community mental health practitioners, managers are encouraged to consider providing TBC intervention.

Interplay of Adolescents' and Parents' Mindsets of Socioeconomic Status on Adolescents' Stress-Related Outcomes.

The reciprocity and variation of values and beliefs are dynamic features of the parent-child relationship. Parents and adolescents may hold congruent or incongruent views regarding the malleability of socioeconomic status (mindset of SES), potentially influencing adolescents' psychological and physiological stress outcomes, as reflected in stress perceptions and the hypothalamic-pituitary-adrenal (HPA) axis functioning. The current study investigated how patterns of parent-adolescent congruence and incongruence in mindset of SES were associated with adolescents' perceived stress and diurnal cortisol patterns four months later. A total of 253 adolescents (Mage = 12.60, 46.2% girls) and their parents (Mage = 40.09 years, 59.5% mothers) participated in this study. Polynomial regression analyses and response surface analyses showed that adolescents perceived lower levels of stress when they themselves or their parents reported a stronger growth mindset of SES. Additionally, adolescents with a stronger growth mindset of SES also exhibited a steeper diurnal cortisol slope. Moreover, parents' mindset significantly interacted with adolescents' mindset to influence adolescents' diurnal cortisol patterns such that when adolescents hold weaker growth mindset of SES, those with higher parental growth mindsets had significantly higher cortisol awakening response and steeper diurnal cortisol slope. Furthermore, adolescents who showed incongruence with their parents but had averagely stronger growth mindsets of SES reported a significantly steeper diurnal cortisol slope than those who had averagely weaker growth mindsets with their parents. The findings point to the beneficial impacts of the growth mindset of SES on stress-related outcomes among adolescents, as well as the significance of considering both parents' and adolescents' mindsets when exploring these associations.

Breaking self-focused orientation in people who perceive economic scarcity: The influence of transcendent motivation to promote an abstract mindset and prosocial behavioral intentions.

Previous research shows that being in a situation of economic scarcity promotes a more concrete mindset that motivates behavioral decisions based on action difficulty and their short-term outcomes, which frequently entails negative consequences. However, a concrete mindset can be counteracted by inducing an abstract mindset to help people focus on final broad goals. We explored how focusing on transcendent motives (vs. self-oriented) promotes a more abstract mindset facilitating prosocial behavioral intentions. Study 1 (pre-post design) explored whether focusing on transcendent motives for engaging in activities promoted a more abstract mindset compared to focusing on self-oriented motives. Using a 2 × 2 design with two consecutive opposing primes, Study 2 tested how inducing a transcendent orientation could reverse the effect caused by perceiving economic scarcity, promoting greater orientation toward others and prosocial behavioral intentions. In Study 1 participants who generated transcendent motives for behaviors presented a greater increase in the abstraction of construal level, compared to those who only generated self-oriented motives for the same behaviors. Study 2 demonstrated that, when participants who perceived economic scarcity were focused on transcendent motives (vs. self-oriented) to promote a more abstract mindset, their orientation toward others increased. Interestingly, for people perceiving economic scarcity, whose own difficulties could reduce prosocial behaviors, the greater orientation toward others promoted a greater intention to engage in demanding prosocial behaviors. We provide evidence of new strategies to promote abstraction in individuals and increase their involvement in prosocial behavioral intentions, especially for those perceiving economic scarcity.

Men, mindsets and birth: results of a prospective longitudinal study.

AIMS/BACKGROUND: In recent years, there has been an increased interested in the contribution of fathers to childbirth. In the present paper we explore whether the father's birth-related mindset (being either more natural or more medical) can predict the mother's labour and birth outcomes and whether the father's experience and evaluation of the birth can predict his psychological well-being after the birth. DESIGN/METHODS: We conducted a longitudinal study (N = 304 expecting fathers) spanning the first trimester of pregnancy up to six months after birth. RESULTS: The study results could be integrated into a Single Indicator Model. They indicated that a father's more natural birth-related mindset predicted low-intervention birth for the mother. A low-intervention birth led to a more positive birth experience for the father, and in turn to better postpartum adjustment, fewer symptoms of postpartum paternal depression eight weeks after birth, and more secure bonding to the infant six months after birth. CONCLUSION: The study results indicate that fathers do not take a merely passive role in childbirth. On the contrary, analogous to pregnant mothers, fathers' views about childbirth might contribute to the course of birth, and their own postpartum psychological well-being. The results of the present study, thus, highlight the importance of fathers for childbirth and in a broader sense, the results also contribute to a better understanding of the psychological framework of birth and represents a valuable starting point for further research.

A pilot study of performance enhancement coaching for newly appointed urology registrars.

OBJECTIVES: To assess the feasibility of performance enhancement coaching (PEC) for newly appointed Urology registrars (ST3s), specifically: whether the concept appealed, and which areas beyond technical skills acquisition were felt to be most relevant or useful. SUBJECTS AND METHODS: All delegates on the Urology Bootcamp 2023 were invited to take part in an online survey before and after a 2-hour PEC workshop, collecting: basic demographic data, performance challenges, and the important aspects to include in, and consider with, a coaching programme. The workshop was delivered by a surgeon with a professional coaching qualification, to groups of four delegates at a time over 4 days. Ten pre-defined areas were offered during the session. RESULTS: On a scale of 1 (poor) to 10 (excellent), the 62 participants' overall health was reported as a median of 8/10 (physical) and 7/10 (mental). Anxiety during performance was the most common concern (63%) and was accompanied by a tremor in 55%. The next most popular concerns, with 19% of responses each, were: sleep, insufficient operative skill or expertise, and worry about relationships with trainers. The commonest topics discussed were 'the inner critic' (100%), 'autonomic modulation' (69%), 'not working, well' (13%) and 'optimising study' (6%). Seventy-seven per cent were unaware of PEC for practising surgeons. All respondents felt that they would benefit from PEC to some extent (80% ≥8/10 where 10/10 was 'very useful'), ideally at the ST3 level. Sixty-two percent of respondents said there should be a fee for trainees, whereas 38% thought it should be free and paid for by their training authorities. CONCLUSION: The concept of PEC is acceptable to ST3 Urology trainees, with particular interest in techniques to mitigate negative self-talk and autonomic modulation techniques. Existing barriers to coaching for the surgical community would need to be addressed in designing an acceptable coaching programme.

Left-behind cumulative risk and academic adjustment in Chinese middle school students: The moderating effect of growth mindset.

Left-behind children, as a large-scale disadvantaged group, encounter an array of risk factors that impede their academic development because of parental migration. The current study aimed at investigating the roles of left-behind cumulative risk and growth mindset on academic adjustment and exploring whether growth mindset moderated the association between left-behind cumulative risk and academic adjustment in left-behind middle school students. A total of 1184 left-behind middle school students (615 males; 12-16 years) participated in the study. Results indicated that left-behind cumulative risk is negatively associated with academic adjustment in middle school students (ß = -.199, t(1183) = -7.229, p < .001). Besides, growth mindset has a protective effect on left-behind middle school students' academic adjustment (ß = .386, t(1183) = 14.070, p < .001) and a moderating effect on the relationship between left-behind cumulative risk and academic adjustment (ß = .394, t(1182) = 4.057, p < .001, ΔR2 = .012). These findings suggest that family risk factors related to left-behind status affect the academic adjustment of left-behind middle school students in a superposition way, while the positive individual factor of growth mindset could protect the negative impact caused by parental migration.

New ACGME Clinician Educator Milestones as a Roadmap for Faculty Development: a Position Paper from the Society of General Internal Medicine Education Committee.

Traditionally, clinician educators are tasked with the responsibility of training future physician workforce. However, there is limited identification of skills required to fulfill this responsibility and a lack of consensus on effective faculty development for career growth as a clinician educator. The newly released Accreditation Council of Graduate Medical Education (ACGME) Clinician Educator (CE) Milestones framework outlines important skills for clinician educators and provides the opportunity to create robust faculty development. In this paper, members of the Society of General Internal Medicine Education Committee discuss the importance of these CE Milestones, outline the novel themes highlighted in the project, and provide recommendations for proper application on both the individual and institutional levels to optimize faculty development. The paper discusses strategies for how to apply the CE Milestones as a tool to create a culture of professional growth and self-directed learning. Using a reflective approach, CE faculty and mentors can identify areas of proficiency and opportunities for growth, thereby creating individualized professional development plans for career success. Institutions should use aggregate CE Milestones data as a needs assessment of their faculty "population" to create targeted faculty development. Most importantly, institutions should not use CE Milestones for high-stakes assessments but rather encourage reflection by CE faculty and create subsequent robust faculty development programs. The ACGME CE Milestones present an exciting opportunity and lay an important foundation for future CE faculty development.