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Differences in Resident Self-Evaluation and Clinical Competency Committee Evaluation Using ACGME Milestone Versions
Savitha Baragada1, Brandon Petree1, May Tee2
1MercyOne Medical Center, General Surgery Residency, Des Moines, Iowa.
Journal of Surgical Education
|August 12, 2023
Summary
Surgical residents’ self-evaluations of competency differ from faculty assessments, with a notable overestimation in Milestones 2.0 compared to Milestones 1.0. This discrepancy impacts male residents more significantly, highlighting a need for improved self-awareness in surgical training.
Area of Science:
- Medical Education
- Surgical Training
- Competency Assessment
Background:
- Self-driven professional development is crucial for surgical residents.
- Entrustable Professional Activities (EPAs) are emerging as a new paradigm in surgical education.
- Understanding resident self-perception versus faculty evaluation is key for effective training.
Purpose of the Study:
- To compare self-rated competency assessments by surgical residents with evaluations from the Clinical Competency Committee (CCC).
- To analyze discrepancies using both ACGME Milestones Version 1.0 (M1.0) and Version 2.0 (M2.0).
Main Methods:
- 22 general surgical residents provided semiannual self-evaluations from 2017 to 2022.
- Clinical Competency Committee (CCC) evaluations were conducted independently.
- 1552 paired data points were analyzed using paired Wilcoxon signed-rank tests.
Main Results:
- Residents' M1.0 self-evaluations were lower than CCC evaluations (p < 0.001), with differences in specific competencies (MK, PBLI, PC, SBP).
- Residents' M2.0 self-evaluations were higher than CCC evaluations (p < 0.001) across all 6 competencies.
- Multivariate regression showed gender, PGY level, and Milestone version significantly predicted assessment discordance (R²=0.255).
Conclusions:
- Discrepancies between resident self-assessment and CCC evaluations are more pronounced with M2.0 than M1.0.
- Residents tend to overestimate their competencies using M2.0 compared to faculty assessments.
- This overestimation is more significant in male residents, indicating a need for enhanced self-awareness training.
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