Identification of high-risk residents

Area of Science:

• Medical Education Research
• Surgical Training
• Resident Performance Evaluation

Background:

• Identifying residents with suboptimal performance is essential for targeted remediation and administrative actions.
• This study investigates documentation differences for marginally performing residents in general surgery training.

Purpose of the Study:

• To characterize documentation differences between high-risk and control residents in a general surgery program.
• To identify early indicators of poor performance in surgical trainees.

Main Methods:

• A case-control study compared 24 high-risk residents with matched controls over a 10-year period.
• Resident records were analyzed for demographics, pre-entry qualifications, American Board of Surgery In-Training Exam (ABSITE) scores, faculty letters, counseling events, and monthly evaluations.
• Statistical analysis included Wilcoxon signed ranks and McNemar tests.

Main Results:

• Objective data were similar between groups, but high-risk residents showed significantly higher monthly evaluation scores by Year 3 (p=0.026).
• High-risk residents were more likely to receive negative faculty letters (p=0.016) and experience counseling events (p=0.017 for faculty, p=0.005 for program director).

Conclusions:

• Early identification of at-risk residents is vital for effective training program management.
• A combination of faculty evaluations and counseling records can help detect residents needing support.
• These indicators can inform decisions about remedial interventions or administrative actions for underperforming residents.