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The McMaster Modular Assessment Program (McMAP): A Theoretically Grounded Work-Based Assessment System for an

Teresa Chan1, Jonathan Sherbino,

  • 1T. Chan is assistant professor, Division of Emergency Medicine, Department of Medicine, McMaster University Michael G. DeGroote School of Medicine, Hamilton, Ontario, Canada, and student, Master of Health Professions Education Program, University of Illinois College of Medicine, Chicago, Illinois. J. Sherbino is associate professor, Division of Emergency Medicine, Department of Medicine, McMaster University Michael G. DeGroote School of Medicine, and adjunct scientist, Program for Educational Research and Development, McMaster University, Hamilton, Ontario, Canada.

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Summary

The McMaster Modular Assessment Program (McMAP) improved emergency medicine resident evaluations by using multiple work-based assessments. This system enhanced report quality and normalized daily feedback, fostering a better learning culture.

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Area of Science:

  • Medical Education
  • Competency-Based Assessment
  • Emergency Medicine Training

Background:

  • Generalist residency programs, like emergency medicine (EM), require comprehensive work-based assessments (WBAs) to evaluate resident competence.
  • Integrating qualitative and quantitative data from WBAs is crucial for accurate performance evaluation in broad-based training.
  • Existing assessment methods may rely on limited data, potentially impacting the reliability of resident competence evaluation.

Purpose of the Study:

  • To evaluate the effectiveness of the McMaster Modular Assessment Program (McMAP) in assessing resident competence in emergency medicine.
  • To determine if McMAP improves the quality of end-of-rotation reports compared to previous assessment methods.
  • To assess the impact of McMAP on the culture of feedback within the residency program.

Main Methods:

  • Implementation of McMAP, a programmatic assessment system using 42 WBA instruments aligned with EM tasks and CanMEDS competencies.
  • Instruments included checklists, performance ratings, and written comments completed by faculty after direct observation.
  • Aggregated WBA data informed end-of-rotation qualitative global assessments by rotation preceptors.

Main Results:

  • Significant improvement in the quality of end-of-rotation reports post-McMAP implementation (P < .001).
  • Enhanced report quality attributed to aggregated data from multiple raters throughout the rotation.
  • Shift from single-faculty recall to data-driven assessments, improving reliability and depth of evaluation.

Conclusions:

  • McMAP effectively aligns assessment instruments with authentic EM tasks, fostering a culture of normalized daily feedback.
  • The system provides a robust framework for assessing resident competence through integrated qualitative and quantitative data.
  • Future work includes managing 'big data' in assessment and establishing clear policies for promotion decisions.