"It Changed How I Think"-Impact of Programmatic Assessment Upon Practicing Physicians: A Qualitative Study

Area of Science:

• Medical Education
• Assessment and Evaluation

Background:

• Programmatic assessment systematically documents learner performance using varied feedback and assessment stakes.
• Existing research indicates positive learner and faculty perceptions of programmatic assessment's impact on goal setting and feedback.
• The Cleveland Clinic Lerner College of Medicine (CCLCM) has utilized programmatic assessment for over 18 years.

Purpose of the Study:

• To explore physician graduates' perceptions of their experiences with programmatic assessment during and after medical school.
• To identify themes related to self-determination theory and professional identity formation within graduates' assessment experiences.

Main Methods:

• A qualitative study involving interviews with 26 physician graduates from CCLCM (classes of 2009-2019).
• Purposeful sampling ensured representation across class cohorts, clinical specialties, and practice locations.
• Thematic analysis of interview transcripts was conducted, guided by self-determination theory and professional identity formation frameworks.

Main Results:

• Graduates reported positive experiences with programmatic assessment, particularly its role in facilitating goal navigation and self-reflection.
• Key themes emerged regarding the influence of assessment on professional identity formation and learner autonomy.
• Specific examples and quotes from graduates illustrate the perceived benefits and challenges of the assessment system.

Conclusions:

• Programmatic assessment, as implemented at CCLCM, is perceived favorably by graduates, contributing to their professional development.
• Recommendations are provided for institutions implementing or considering programmatic assessment strategies.
• Further research is suggested to explore long-term impacts and refine programmatic assessment models.