Self-evaluation by house officers in a primary care training program.

Area of Science:

• Medical Education
• Ambulatory Care
• Internal Medicine

Background:

• Ambulatory care expertise demands extensive knowledge and skills.
• Primary care internal medicine training programs must equip residents for diverse clinical scenarios.

Purpose of the Study:

• To identify essential diagnostic, management, and procedural skills for internal medicine residents in ambulatory care.
• To assess resident confidence levels in these skill areas throughout their training.

Main Methods:

• A modified Delphi survey technique was employed to define key competencies.
• Self-evaluation instruments were developed for residents to rate their abilities.
• A longitudinal assessment tracked changes in resident confidence over time.

Main Results:

• Residents entered training with higher confidence in diagnostics than in management or procedural skills.
• Confidence increased across most areas during training, excluding behavioral sciences.
• The self-evaluation method provided insights into training program effectiveness.

Conclusions:

• The study highlights specific skill domains crucial for ambulatory care competence in internal medicine.
• Resident confidence evolves during training, with notable gains in clinical skills but stagnation in behavioral sciences.
• Self-evaluation tools are valuable for assessing training progress and program efficacy.