Resident Competency in Pelvic Exam Skills Not Predicted by Early Assessment

Area of Science:

• Medical Education
• Gynecology Training

Background:

• Pelvic examination training and assessment are resource-intensive.
• Objective: Identify residents needing additional training early in residency using skill evaluations.

Purpose of the Study:

• To evaluate the effectiveness of early resident skill assessments in predicting competency in pelvic examinations.

Main Methods:

• Incoming residents performed pelvic exams observed by faculty and teaching assistants.
• Written assessments were completed by faculty and teaching assistants.
• A regression model identified early performance indicators for subsequent competency.

Main Results:

• 56% of residents did not demonstrate competency in three clinical exams.
• "Identifies cervix" and "properly assembles equipment" were key predictors.
• The predictive model had 100% sensitivity but only 36.8% specificity.

Conclusions:

• The early skills assessment model lacked sufficient specificity for identifying residents needing further training.
• Recommendations include limiting faculty assessors, enhancing faculty development, and refining feedback and competency documentation processes.