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Building a Better Clinical Competency Committee: A Multi-Institutional Approach to Improving the Quality of Resident
Nikita Khetan1, Emma Omoruyi1, Elizabeth Hanson2
1McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, Texas.
Background:
The Accreditation Council for Graduate Medical Education (ACGME) requires pediatric faculty to convene twice yearly as a Clinical Competency Committee (CCC) to review resident performance and provide feedback. Variability in review processes and limited feedback quality remain common challenges. Incorporating Appreciative Inquiry within a Deliberate Practice framework may enhance the quality of summative feedback provided to residents.
Methods:
This project was conducted with pediatric residents and faculty during the 2019-20 academic year at The University of Texas Health Science Center at Health San Antonio (UTHSA) and during the 2021-22 academic year at The University of Texas Health Science Center at Houston (UTH). Appreciative Inquiry guided development of anonymous surveys for residents and faculty, with responses analyzed and themed to inform improvements in the CCC process. Deliberate Practice provided the framework for defining and assessing feedback quality. Resident satisfaction with CCC feedback was evaluated pre- and post-intervention using Deliberative Practice-based surveys. At UTHSA, de-identified feedback was further assessed using the Task-Gap-Action (TGA) rubric.
Results:
Resident survey response rates were 79% pre-intervention and 39% post-intervention; faculty response rates were 50% at UTHSA and 75% at UTH. Appreciative Inquiry-derived themes informed the development of a new CCC summative feedback form aligned with milestone evaluations. Resident satisfaction with feedback improved at both institutions, and the mean TGA scores increased from 2.5/9 to 8/9 at UTHSA.
Conclusion:
Appreciative Inquiry is a feasible approach to identifying the needs of learners and faculty in the feedback process. By collaboratively implementing this approach within the CCCs at our respective institutions, we were able to positively affect the feedback given to residents across 2 programs. Additionally, the TGA rubric offered valuable insight into feedback produced by the CCC to support the growth of resident trainees.
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