Competencies and Feedback on Internal Medicine Residents' End-of-Rotation Assessments Over Time: Qualitative and Quantitative Analyses.
Acad Med. 2019 Jun 04;:
Authors: Tekian A, Park YS, Tilton S, Prunty PF, Abasolo E, Zar F, Cook DA
PURPOSE: To examine how qualitative narrative comments and quantitative ratings from end-of-rotation assessments change for a cohort of residents from entry to graduation, and explore associations between narrative feedback and quantitative ratings.
METHOD: The authors obtained end-of-rotation quantitative ratings and narrative comments for one cohort of internal medicine residents at the University of Illinois at Chicago College of Medicine over three years, July 2013-June 2016. They inductively identified themes in comments, coded orientation (praising/critical) and relevance (specificity and actionability) of feedback, examined associations between codes and ratings, and evaluated changes in themes and ratings across years.
RESULTS: Data comprised 1,869 assessments (828 comments) on 33 residents. Five themes aligned with ACGME competencies (interpersonal and communication skills, professionalism, medical knowledge, patient care, and systems-based practice) and three did not (personal attributes, summative judgement, and comparison to training level). Work ethic was the most frequent subtheme. Comments emphasized medical knowledge more in year 1 and focused more on autonomy, leadership, and teaching in later years. Most comments (714/828 [86%]) contained high praise and 412/828 (50%) were very relevant. Average ratings correlated positively with orientation (β = 0.46, P < .001) and negatively with relevance (β = -0.09, P = .01). Ratings increased significantly with each training year (year 1, mean [standard deviation]: 5.3 [0.6]; year 2: 5.6 [0.5]; year 3: 5.9 [0.4]; P < .001).
CONCLUSIONS: Narrative comments address resident attributes beyond the ACGME competencies and change as residents progress. Lower quantitative ratings are associated with more specific and actionable feedback.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
PMID: 31169541 [PubMed - as supplied by publisher]