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Beyond Milestones


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Some months ago, a few local consultants returned from a conference in Sydney. They were abuzz with stories of a new learning resource for professional education around behaviour and development. A Sydney Developmental Paediatrician had compiled these videos, and they were ‘just fantastic’, but at the time apparently very hard to get a look at.

Fast forward to this month’s edition of the Journal of Paediatrics and Child health, where Drs Connolly, Cunningham and team have explained the videos, the associated learning package and measured its benefits. The password to access this is ‘cunningham’ – (reproduced here with permission from the Journalof Paediatrics and Child Health).

Connolly, A. M., Cunningham, C., Sinclair, A. J., Rao, A., Lonergan, A. and Bye, A. M. (2014), ‘Beyond Milestones’: A randomised controlled trial evaluating an innovative digital resource teaching quality observation of normal child development. Journal of Paediatrics and Child Health, 50: 393–398. doi: 10.1111/jpc.12485

What was the aim of the study?

The study sought to assess the efficacy of an educational resource aimed at teaching a “systematic approach to critical and quality observation of normal child development.”

Who were the participants?

 56 paediatric trainees from the Sydney Children’s Hospitals Network in NSW, Australia.

What was the intervention?

 One group was provided teaching and access to a digital resource “Beyond Milestones”  compared with no teaching intervention.

Specifically, “Beyond Milestones” is a package of the videos. These include an expert developmental paediatrician discussing some of the tools and an approach to developmental assessment. In subsequent videos, the paediatrician formally assesses a number of children aged from 9-54 months.

Written informed consent was obtained from the parents to use the footage on the internet.

The trainees were assessed prior, immediately-post and one month after the intervention. There were asked to observe a video of two children and assess their development. Additionally, trainees were surveyed regarding the usefulness of the intervention and their attitudes around performing a developmental assessment.

What was the outcome?

 Those trainees undertaking the educational intervention found it useful. The teaching group was more confident in their developmental skills. Assessment of the trainees showed greater knowledge, with improved knowledge of markers of development and observational expertise.

I think the “Beyond Milestones” program is a great resource. It focuses on an area that many trainees and paediatric consultants feel their knowledge and skill can be vastly improved. Develpomental assessment is a challenging skill to develop well. As one of the participants says:

‘. . . really delightful to watch the concepts come alive, we hardly get the opportunity to sit in on developmental clinics, so this has made it really accessible and therefore very helpful’

As I’ve said above, the reputation of “Beyond Milestones” utility preceded my knowledge of the article itself. The paper quite nicely shows that the trainees found it both subjectively and objectively useful.

Interestingly, this is pretty close to institutional FOAMped, and word of its strength filtered through conventional channels as well. I strongly suggest watching the videos, there are fourteen in total. I’m working through them and as the paper itself best says:

“The standard and depth of the teaching coupled with its interactive style make it applicable to those with a basic level of knowledge to those interested in more sophisticated and subtle teaching points.”



The Beyond Milestones learning package can be accessed at with the password cunningham
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About the authors

  • A General Paediatrician and Adolescent Medicine Fellow based in Queensland, Australia, Henry is passionate about Health Systems and Complex Care, with a strong interest in Medical Education & Clinical Teaching. His 'Dad jokes' significantly pre-date fatherhood, and he stays well by running ultramarathons. @henrygoldstein | + Henry Goldstein | Henry's DFTB posts


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