Resident Readiness for Senior Level Decision Making: Identifying the Domains for Formative Assessment and Feedback

Area of Science:

• Surgical Education
• Medical Assessment
• Resident Training

Background:

• Senior surgery residents require defined competencies for critical decision-making and advanced responsibilities.
• The American College of Surgeons (ACS) identified a need for a standardized assessment tool for resident readiness.

Purpose of the Study:

• To establish expert consensus on domains and topics for senior surgery resident (PGY-4) readiness.
• To develop the formative American College of Surgeons Senior Resident Readiness Assessment (ACS SRRA) Program.

Main Methods:

• A focus group of surgical experts identified initial content.
• A modified Delphi methodology with three rounds of online surveys was used for national expert consensus.
• Consensus was defined as ≥80% agreement, with reliability assessed by Cronbach's alpha (≥0.8).

Main Results:

• A 100% response rate was achieved across all Delphi rounds, with Cronbach's alpha ≥0.9.
• Initial evaluation of 201 topics resulted in the inclusion of 120 topics within 25 core clinical areas for the ACS SRRA.
• Expert consensus was achieved on the domains for the ACS SRRA.

Conclusions:

• The modified Delphi method successfully established national consensus among expert surgical educators for the ACS SRRA domains.
• The ACS SRRA will pinpoint areas for improvement in senior residents' clinical knowledge and skills.
• This assessment tool will facilitate individualized learning plans, enhancing resident preparedness for practice and fellowship training.