Adam Schatz1, Barry Kogan2, Paul Feustel2. 1. Department of Urology, Albany Medical College, Albany, New York. Electronic address: schatza@mail.amc.edu. 2. Department of Urology, Albany Medical College, Albany, New York.
Abstract
OBJECTIVE: Training programs must ensure residents are competent to practice independently. For surgical fields, this is generally done by the faculty who graduate the residents, but there has been no accepted methodology for this process. DESIGN: As part of a generalized survey, attending physicians performing an operation were asked to assess resident competency to perform the operation independently in an average patient, using a single global question. Residents, in a blinded manner, were asked to answer the same question. SETTING: Urology Residency Program, Albany Medical College, Albany, NY. PARTICIPANTS: Participants included 12 resident physicians and 10 attending physicians. RESULTS: There is a large variation in attending physician assessment of resident surgical competency, and the assessment varies by attending physician and by resident. Generally, attending physicians rated residents lower than the residents rated themselves. The discrepancy was largest for residents early in training and lessened as resident experience increased. Assessments also tended to converge toward the attending physician assessment as competency increased. Assessments had less variability when involving a single, high-volume procedure for a single resident. CONCLUSIONS: Assessing resident surgical competency with a standardized global question is feasible, but complex. Attending physicians and residents differ significantly in their assessment of resident competence. The trend of residents׳ perceptions approaching attending physician estimates as training and competence increases supports the current concept that program directors should use attending physician assessments as the primary measure.
OBJECTIVE: Training programs must ensure residents are competent to practice independently. For surgical fields, this is generally done by the faculty who graduate the residents, but there has been no accepted methodology for this process. DESIGN: As part of a generalized survey, attending physicians performing an operation were asked to assess resident competency to perform the operation independently in an average patient, using a single global question. Residents, in a blinded manner, were asked to answer the same question. SETTING: Urology Residency Program, Albany Medical College, Albany, NY. PARTICIPANTS: Participants included 12 resident physicians and 10 attending physicians. RESULTS: There is a large variation in attending physician assessment of resident surgical competency, and the assessment varies by attending physician and by resident. Generally, attending physicians rated residents lower than the residents rated themselves. The discrepancy was largest for residents early in training and lessened as resident experience increased. Assessments also tended to converge toward the attending physician assessment as competency increased. Assessments had less variability when involving a single, high-volume procedure for a single resident. CONCLUSIONS: Assessing resident surgical competency with a standardized global question is feasible, but complex. Attending physicians and residents differ significantly in their assessment of resident competence. The trend of residents׳ perceptions approaching attending physician estimates as training and competence increases supports the current concept that program directors should use attending physician assessments as the primary measure.
Keywords:
Medical Knowledge; Patient Care; Practice-Based Learning and Improvement; competency-based education; program evaluation; resident evaluation; self-evaluation; surgical training
Authors: Diego M Carrion; Moises E Rodriguez-Socarrás; Guglielmo Mantica; Francesco Esperto; Angelika Cebulla; Diederick Duijvesz; Giulio Patruno; Juan L Vásquez; Domenico Veneziano; Jesús Díez-Sebastian; Ali S Gozen; Joan Palou; Juan Gómez Rivas Journal: World J Urol Date: 2019-04-13 Impact factor: 4.226