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How accurate are faculty evaluations of clinical competence?
J E Herbers1, G L Noel, G S Cooper
1Department of Medicine, Walter Reed Army Medical Center, Washington, DC 20307-5001.
Journal of General Internal Medicine
|May 1, 1989
Summary
Faculty evaluations of residents show significant variability in observations and documentation. Specific forms and observer training are needed for the American Board of Internal Medicine Clinical Evaluation Exercise (CEX) to be effective for resident feedback.
Area of Science:
- Medical Education
- Internal Medicine Training
- Clinical Skills Assessment
Background:
- Faculty evaluations are crucial for resident development in internal medicine.
- The American Board of Internal Medicine (ABIM) Clinical Evaluation Exercise (CEX) is a key assessment tool.
- Variability in faculty assessment can hinder effective resident feedback.
Purpose of the Study:
- To quantify the variability in faculty evaluations of residents during the ABIM CEX.
- To identify the sources contributing to this assessment variability.
Main Methods:
- Utilized videotaped simulated CEX scenarios with programmed resident performance.
- Faculty evaluators used ABIM-recommended open-ended forms and detailed questionnaires.
- Thirty-two faculty internists evaluated resident performance on a five-point scale.
Main Results:
- Faculty documented few resident strengths/weaknesses on open-ended forms, despite observing them.
- Significant variance existed in global resident assessments (marginal, failed, satisfactory).
- Variability was linked to differing standards only in areas unrelated to patient problems.
Conclusions:
- Faculty internists exhibit marked variability in observing and documenting resident performance.
- The current CEX format may require more specific documentation tools.
- Training faculty evaluators as observers could improve assessment consistency and utility.