The development of a competency-based assessment rubric to measure resident milestones.

BACKGROUND: The outcomes-based assessment rubric is a novel systematic instrument for documenting improvement in clinical learning. APPROACH: This article describes the development of a rubric aimed at introducing specific performance indicators to measure the Accreditation Council for Graduate Medical Education competencies. RESULTS: The potential benefits and implications for medical education include specifying performance indicators and outcomes, ensuring that assessment is coherent and consistent for all residents, measuring resident outcomes based on real-life criteria, providing opportunities for residents to demonstrate proficiency in a specific competency and outcome level, and improving the quality of assessment.