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Evaluating Resident Procedural Skills: Faculty Assess a Scoring Tool.

Jack Wells1, Alicia Ludden-Schlatter1, Robin L Kruse1

  • 1Department of Family and Community Medicine, School of Medicine, University of Missouri, Columbia, MO.

Primer (Leawood, Kan.)
|June 16, 2020
PubMed
Summary

The Procedural Competency Assessment Tool (PCAT) shows low reliability in assessing family medicine residents, with results varying significantly. Modifications and faculty training may improve its use in procedural skills assessment.

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Area of Science:

  • Medical Education
  • Residency Training
  • Procedural Skills Assessment

Background:

  • Procedural skills assessment is vital for residency training.
  • The Council of Academic Family Medicine endorses the Procedural Competency Assessment Tool (PCAT) for family medicine residents.
  • The reliability and limitations of the PCAT require evaluation.

Purpose of the Study:

  • To evaluate the reliability of the PCAT.
  • To identify strengths and limitations of the PCAT in assessing procedural competence.

Main Methods:

  • A mixed-methods study involving 18 faculty members assessing a simulated shave biopsy.
  • Faculty used the original PCAT, participated in focus groups, and then used a modified PCAT with objective criteria.
  • Qualitative analysis explored perceived benefits and challenges of the PCAT.

Main Results:

  • Competency ratings dropped from 40% to 21.4% with the modified PCAT (P=.035).
  • Respondents rated physicians as competent despite scoring procedure components as novice.
  • Qualitative data indicated the PCAT is subjective, leading to wide interpretation variability.

Conclusions:

  • Further research on PCAT validity and reliability is necessary.
  • The PCAT may need additional objective criteria for improved reliability.
  • Residencies could train faculty on PCAT use or adopt more intuitive checklist tools.