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Justifications for Discrepancies Between Competency Committee and Program Director Recommended Resident Supervisory
Daniel J Schumacher1, Sue Poynter1, Natalie Burman2
1Department of Pediatrics (DJ Schumacher, S Poynter, and J Gonzalez del Rey), Cincinnati Children's Hospital Medical Center/University of Cincinnati, Ohio.
Academic Pediatrics
|December 21, 2018
Summary
Program directors (PDs) and clinical competency committee (CCC) members differ in justifying pediatric resident supervisory roles. PDs emphasize performance for advancement but experience for demotion, questioning competency-based progression.
Area of Science:
- Medical Education
- Pediatric Residency Training
- Competency-Based Assessment
Background:
- Summative entrustment decisions in pediatric residency are made by clinical competency committee (CCC) members and program directors (PDs).
- Discrepancies between CCC and PD decisions can impact resident progression and evaluation.
Purpose of the Study:
- To investigate the reasons behind differences in summative entrustment decisions between CCC members and PDs for pediatric residents.
- To analyze the justifications used by PDs when their decisions diverge from CCC recommendations.
Main Methods:
- A review of 801 supervisory role categorizations from 14 pediatric residency programs (2015-2016).
- Manifest content analysis of free-text justifications provided by PDs for discrepancies with CCC decisions.
- Categorization of residents into 5 progressive supervisory roles.
Main Results:
- Discrepancies occurred in 116 out of 801 categorizations.
- PDs more frequently assigned lower supervisory roles (73 instances) than higher ones (43 instances) when differing from CCCs.
- PD justifications focused on resident performance for advancement and experience for demotion.
Conclusions:
- PD justifications for advancing residents emphasize performance, while justifications for lowering roles emphasize experience.
- These differing justification patterns may warrant further investigation regarding their alignment with competency-based medical education principles.
- Understanding these discrepancies is crucial for consistent and fair resident evaluation.
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