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Do global rating forms enable program directors to assess the ACGME competencies?
Cynthia G Silber1, Thomas J Nasca, David L Paskin
1Graduate Medical Education, Jefferson Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania 19107,USA. cynthia.silber@jefferson.edu
Summary
Global rating forms may not adequately assess the six general competencies mandated by the Accreditation Council for Graduate Medical Education (ACGME). Physicians perceive competence in two dimensions, questioning the premise of six distinct competencies.
Area of Science:
- Medical Education
- Graduate Medical Education
- Competency-Based Education
Background:
- The Accreditation Council for Graduate Medical Education (ACGME) mandated six general competencies for resident proficiency.
- Assessing these competencies is crucial for effective medical training and patient care.
Purpose of the Study:
- To determine if an existing global rating form could be adapted to evaluate the six ACGME general competencies.
- To investigate the validity of assessing distinct competencies versus broader dimensions of physician competence.
Main Methods:
- A rating form assessing 23 skills within the ACGME competencies was developed.
- Program directors at two institutions rated residents over two academic years.
- Factor analysis was used to explore the underlying structure of perceived competence.
Main Results:
- Ratings for 95% of residents were analyzed.
- Residents received highest ratings for professionalism, compassion, and empathy.
- Lowest ratings were for cost consideration and resource management.
- Factor analysis revealed two primary dimensions: medical knowledge and interpersonal skills.
- Competence ratings increased with resident training level.
Conclusions:
- Global rating forms may be insufficient for assessing the six distinct ACGME competencies.
- Findings suggest physicians perceive competence in two broad dimensions, challenging the ACGME's six-competency model.
- Further research is needed to validate distinct measures for clinical competence.