• Medical teacher · Oct 2017

    How do clinical competency committees use different sources of data to assess residents' performance on the internal medicine milestones?A mixed methods pilot study.

    • Andem Ekpenyong, Elizabeth Baker, Ilene Harris, Ara Tekian, Richard Abrams, Shalini Reddy, and Yoon Soo Park.
    • a Internal Medicine , Rush University Medical Center , Chicago , IL , USA.
    • Med Teach. 2017 Oct 1; 39 (10): 1074-1083.

    PurposeThis study examines how Clinical Competency Committees (CCCs) synthesize assessment data to make judgments about residents' clinical performances.MethodsBetween 2014 and 2015, after four six-month reporting periods to the Accreditation Council for Graduate Medical Education (ACGME), 7 of 16 CCC faculty at Rush University Medical Center completed questionnaires focused on their perspectives about rating residents on their achievement of the milestones and participated in a focus group. Qualitative data were analyzed using grounded theory. Milestones ratings for two six-month ACGME reporting cycles (n = 100 categorical residents) were also analyzed.ResultsCCC members weighted resident rotation ratings highest (weight = 37%), followed by faculty rotation comments (weight = 27%) and personal experience with residents (weight = 14%) for making judgments about learner's milestone levels. Three assessment issues were identified from qualitative analyses: (1) "design issues" (e.g. problems with available data or lack thereof); (2) "synthesis issues" (e.g. factors influencing ratings and decision-making processes) and (3) "impact issues" (e.g. how CCC generated milestones ratings are used).ConclusionsIdentifying factors that affect assessment at all stages of the CCC process can contribute to improving assessment systems, including support for faculty development for CCCs. Recognizing challenges in synthesizing first and second-hand assessment data is an important step in understanding the CCC decision-making process.

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