Programmatic Assessment in Emergency Medicine: Implementation of Best Practices

Programmatic assessment is the intentional collection of key data from multiple sources for both assessment of learning and assessment for learning.

We developed a system of programmatic assessment (PA) to identify competency progression (summative) and assessment for learning to assist residents in their formative development.

The programmatic assessment was designed iteratively from 2014 through 2016. All assessments were first categorized by competency domain and source of assessment. The number of assessment modalities for each competency domain was collected. These multisource assessments were then mapped by program leadership to the milestones to develop a master PA blueprint. A resident learning management system provided the platform for aggregating formative and summative data, allowing residents and faculty ongoing access to guide learning and assessment. A key component of programmatic assessment was to support resident integration of assessment information through feedback by faculty after shifts and during monthly formal assessments, semiannual resident reviews, and summative judgments by the Clinical Competency Committee.

Through the PA, the 6 competency domains are assessed through multiple modalities: patient care (22 different assessments), professionalism (18), systems-based practice (17), interprofessional and communication skills (16), medical knowledge (11), and practice-based learning and improvement (6). Each assessment provides feedback to the resident in various formats. Our programmatic assessment has been utilized for more than 2 years with iterative improvements.

The implementation of programmatic assessment allowed our program to organize diverse, multisourced feedback to drive both formative and summative assessments.