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Using Learning Outcome Measures to assess Doctoral Nursing Education
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Judging residents' performance: a qualitative study using grounded theory.

Marrigje E Duitsman1, Cornelia R M G Fluit2, Wieke E van der Goot3,4

  • 1Department of Internal Medicine and Health Academy, Radboud Health Academy, Radboud University Medical Centre, Gerard van Swietenlaan 4, Postbus 9101, 6500, HB, Nijmegen, the Netherlands. Marloes.Duitsman@radboudumc.nl.

BMC Medical Education
|January 10, 2019
PubMed
Summary

Program directors value faculty feedback over assessment tools for judging resident performance. Residents, however, believe assessment tools best prove their competency, highlighting a significant gap in performance evaluation understanding.

Keywords:
AssessmentGrounded theoryPostgraduate medical educationProgram directorsresident’s performance

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Area of Science:

  • Medical Education Research
  • Healthcare Professional Development
  • Residency Training Evaluation

Background:

  • Program directors are responsible for summative performance judgments of residents.
  • Limited understanding exists regarding the information program directors utilize and value for these judgments.
  • This study investigates the perspectives of both program directors and residents on performance evaluation processes.

Purpose of the Study:

  • To explore the information sources program directors use to evaluate resident performance.
  • To understand how program directors weigh different types of feedback.
  • To compare program directors' evaluation methods with residents' perceptions of how their performance is assessed.

Main Methods:

  • Conducted 16 semi-structured interviews with residents and program directors in the Netherlands.
  • Included participants from internal medicine, surgery, and radiology specialties.
  • Employed grounded theory methodology with iterative constant comparison for data analysis.

Main Results:

  • Program directors primarily gather information from assessment tools, faculty, and personal experience.
  • Faculty comments hold more weight for directors than formal assessment tool feedback.
  • Residents perceive assessment tools as crucial for demonstrating clinical competency, unaware of the director's reliance on informal faculty input.

Conclusions:

  • A discrepancy exists between residents' perceived proof of performance (assessment tools) and program directors' actual evaluation methods (faculty remarks).
  • Program directors heavily rely on informal faculty discussions rather than structured assessment data.
  • Optimizing resident performance judgment may require enhanced information sharing in group decision-making meetings.