A milestone is an observable marker of an individual’s ability along a developmental continuum. Using milestones to monitor the longitudinal progress of learners helps ensure preparation for independent practice at graduation. The CBVE Milestones are written at distinct levels to describe the expected performance along the trajectory of ability for each competency across the program. Veterinary education programs include pre-clinical instruction that provides the foundation to prepare students for patient management in the authentic workplace. Milestones for the pre-clinical curriculum are identified as Pre-Novice 1 and Pre-Novice 2 where learners are developing competence within controlled and simulated environments. The Novice milestone describes the level of learner development expected at the time of entry into an authentic workplace where variability and ambiguity are expected. In this environment, learners may initially regress because of the complexity encountered. Since the Novice milestone sets minimum expectations for a learner’s entry into the authentic workplace, learners who have not yet reached the Novice milestone for a particular competency may require remediation prior to entry into the clinical environment. Conversely, some learners may enter clinical training at a milestone level higher than Novice. The Advanced Beginner milestone describes the expected development of competence during clinical training and helps ensure an individual is on an appropriate trajectory towards graduation. The Competent milestone describes the expectation for a learner’s entry into their professional career. If this level is not achieved, learners require remediation prior to graduation. Although some learners may achieve the Proficient milestone during the veterinary medical training program, for most learners, this milestone provides a roadmap for continued development after graduation.

In medical education literature, competence is considered a stratified concept that builds upon itself as a learner progresses along the developmental continuum. The foundational, context-independent knowledge and skills that every professional should possess are illustrated in the Pre-Novice milestone descriptions. In the early phases of training, learners encounter simulated exercises within controlled learning environments. As the learner progresses to clinical training, the learning environment becomes context-dependent. In the clinical phase, the learner must consider many factors that are unique to a given case or set of circumstances (i.e., the authentic workplace). In the final phase following graduation, the professional develops personalized competence, or the art of practicing medicine, where they incorporate their own skills, interests, and habits into clinical practice. Here the achievement of proficiency corresponds with an aspirational goal usually achieved by a veterinary professional after some time in the professional work environment. Also critical to this final phase of development is the veterinarian’s ability to incorporate broader perspectives. Milestones are written such that each developmental level builds on the previous one, i.e., it is assumed that the Advanced Beginner milestone includes all the behaviors described for the Novice milestone as well as those for the Advanced Beginner milestone; behaviors are not described again at subsequent levels. The milestones are written in a broad context to support demonstration of individual competencies across multiple workplace-based activities.

Milestones create a shared mental model for learners and educators regarding the progressive development of competence. Milestones may be used to:

• Guide the progression of competence throughout a learner’s training;

• Enable learners to focus their learning activities more effectively;

• Assist instructors in providing feedback to learners;

• Provide clearly defined targets to guide authentic learning and assessment;

• Enable assessors or a team of assessors to determine when a learner has achieved a given milestone or set of milestones and is ready to move to the next phase of training.