Who did the case? Perceptions on resident operative participation

Area of Science:

• Medical Education Research
• Healthcare Quality Improvement
• Resident Competency Assessment

Background:

• The Accreditation Council for Graduate Medical Education (ACGME) case log is a key metric for assessing resident competency.
• Current methods may not accurately reflect residents' actual roles and participation levels during medical procedures.

Purpose of the Study:

• To investigate the agreement between residents and faculty regarding the resident's role and the percentage of a case performed.
• To identify discrepancies in the assessment of resident performance and participation.

Main Methods:

• Residents and faculty independently completed 16-question surveys after each case over three weeks.
• The primary outcome measured was the concordance between resident and faculty reports on role and case contribution.

Main Results:

• Matched survey responses were obtained for 87 cases, revealing significant disagreement.
• Agreement on the percentage of the case performed was 61%, on role was 63%, and on both was 47%.
• Discrepancies were frequently linked to residents overestimating their contribution; less experienced faculty reported more disagreements.

Conclusions:

• A substantial gap exists between resident and faculty perceptions of case involvement and role.
• Accurate assessment of resident participation and competency is crucial for accreditation and self-evaluation.
• Further research into the causes of these disagreements is warranted to enhance medical training and evaluation processes.