Professional Behavior Assessment During Residency Training: Can We Identify Outliers?

Area of Science:

• Medical Education
• Surgical Training
• Professionalism Assessment

Background:

• The American Board of Orthopaedic Surgery (ABOS) Knowledge, Skills, and Behavior (KSB) project established a competency-based framework for orthopaedic surgery residency.
• The ABOS Behavior Tool (ABOSBT) assesses professional behavior across five domains.

Purpose of the Study:

• To analyze two years of ABOSBT assessment results.
• To characterize low score ratings in orthopaedic surgery residents' professional behavior.

Main Methods:

• Reviewed 51,678 ABOSBT assessments from January 2022 to December 2023.
• Analyzed data from 360° assessments and end-of-rotation evaluations.
• Identified low scores and evaluated trends across training years and evaluator types.

Main Results:

• 0.9% of all ABOSBT scores were low; reliability was the most frequent domain for low scores.
• Second- and third-year residents received the greatest number of low scores.
• 360° assessments yielded a higher percentage of low scores compared to end-of-rotation assessments.

Conclusions:

• The ABOSBT effectively identifies residents with professionalism deficiencies for targeted educational improvement.
• Most residents demonstrate professional behavior, but the tool aids in early identification of those needing support.
• Continued tracking of ABOSBT low scores will refine its effectiveness in identifying unprofessional behavior during residency.