A model for the objective assessment of clinical training programs: the initial application to two pulmonary medicine...

A model is presented for the objective assessment of clinical training programs. The model documents the clinical trainee's experience by the diagnoses seen and procedures performed during a full year of experience. It also surveys faculty impressions of the trainee's experience and their judgment of what is necessary to constitute an adequate experience. In the pilot study applying this model to two pulmonary medicine fellowship programs, several important observations were made: (1) faculty members may not have an accurate perception of the fellow's actual clinical experience, (2) faculty impressions of the fellow's experience often do not correspond to their own conception of an adequate clinical experience, (3) interprogram variability exists, (4) pulmonary fellows may have inadequate experience with certain invasive procedures. These observations suggest that wilder application of such a model could provide valuable information to program directors and subspecialty boards. In addition, directors of pulmonary disease training programs have been asked by the American Board of Internal Medicine to establish systems to evaluate, document, and substantiate those components of overall clinical competence considered essential for certification in the subspecialty. The model presented here provides an accurate and efficient means for such evaluation and documentation.