ACAD EMERG MED • January 2003, Vol. 10, No. 1 • www.aemj.org 97
A Novel Approach to Resident Evaluation and theCore Competencies
To the Editor:—Medical educators strive to standardizethe evaluation process of residents in order to achieveappropriate feedback and document proficiency. Stan-dardization would decrease the variability in analysesfor knowledge and practice performance. The Accredi-tation Council for Graduate Medical Education(ACGME) has undertaken a broad ‘‘outcomes project’’that is a long-term initiative to increase emphasis on ed-ucational outcome assessment in the accreditation pro-cess. Residency programs are expected to identify spe-cific learning objectives related to the ACGME’s generalcompetencies, develop objective measures of these com-petencies, and use the derived data to provide continu-ous improvement.
The initial part of the project is that residency pro-grams require residents to obtain competencies in six ar-eas to the level expected of a new practitioner. To accom-plish this, residency programs ‘‘must define the specificknowledge, skills, and attitudes required and provideeducational experiences as needed in order for their res-idents to demonstrate’’ these competencies: Patient Care,Medical Knowledge, Practice-Based Learning and Im-provement, Interpersonal and Communication Skills,Professionalism, and Systems-Based Practice.
In order to comply with the requirements, the ACGMEhas stated that residency programs must demonstrate aneffective plan for continuously assessing residents andfor utilizing these results to improve resident perfor-mance throughout the training period. This plan should
include the use of dependable measures to assess resi-dents’ proficiency in the core competencies.
Residency programs are currently looking at newways to improve and standardize their evaluation forms.Our new ACGME competency focused evaluation datacollection form can be found on the AEM website atwww.aemj.org. It is a one-page form with an accompa-nying two-page descriptive key. The Internet is used todistribute multiple forms to the appropriate evaluatorsand collect responses. It includes the mandated compe-tencies while also evaluating the necessary residency re-view committee (RRC) requirements for each resident.Dichotomous variables are used with an explanatorysheet in order to increase the understanding of the scaleand provide more objective responses. The scale utilizesspecific definitions for the dichotomous variables. Onceevaluations are collected, they are analyzed for interraterreliability to help enhance validity and further increasestandardization. We have submitted our initial attemptsat compliance with the new regulation so that other res-idency programs can offer feedback on improvement ofthis evaluation tool. We expect this model will assistachieving objective residency evaluation. We will bepleased to e-mail our form to anyone interested in usingit or providing comment.—Eric Legome, MD ([email protected]), and Diane Pancu, MD, New York Uni-versity/Bellevue Hospital, New York, NY; Eric Nadel, MD,Harvard Medical School, Boston, MA; and Jeff Manko, MD,New York University/Bellevue Hospital, New York, NY
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