Assessing resident competency in an outpatient setting

The Grand Rapids Family Practice Residency Program has been using an ongoing "spot check" method to evaluate global competencies of family medicine residents in the ambulatory setting. This paper describes and assesses this evaluation method.

During each clinic session, preceptors evaluate residents on core ambulatory clinical skills. Evaluations emphasize direct observation of behaviors. Summative feedback is provided on a quarterly basis. Both residents and faculty were surveyed regarding impressions of this system.

Of the residents surveyed, 88% felt this feedback regarding performance was useful, and 75% were comfortable with the process. Sixty percent felt the assessment was an adequate representation of outpatient skills. Eighty-eight percent of residents wanted to continue the evaluation process. After institution of the program, precepting faculty reported an improvement in their assessment of overall resident performance in an outpatient setting. Faculty also self-reported an increase in direct observation of resident encounters.

Assessing global competencies in an outpatient setting is a way for family medicine programs to evaluate residents, provide feedback on an ongoing basis, and monitor growth in key areas. This method was well accepted at our program and has been shown to change self-reported preceptor behaviors regarding direct observation of residents.