Evaluation of Resident Physicians Inpatient Clinical Performance Using a DRG-Based Weighted TOPSIS-RSR Model: A Single-Centre Pilot Study

Clinical practice performance is fundamental for resident physicians. The purpose of this study was to explore evaluation indicators and methods for assessing the clinical practice performance of resident physicians.

We selected resident physicians from their second training stage at a tertiary Class A hospital in 2019 as study subjects. Six Diagnosis-Related Group (DRG) indicators from five dimensions were extracted from residents' clinical case portfolios to initially form the evaluation system, including the number of DRGs, the total weight, the Case Mix Index (CMI), the Cost Expenditure Index (CEI), the Time Expenditure Index (TEI), and the mortality rate in the medium- and low-risk group, with weights summing to 1.00. The weighted Technique for Order Preference by Similarity to an Ideal Solution (TOPSIS) method was then used to evaluate clinical practice performance. Residents were ranked by C_i values, and the Rank Sum Ratio (RSR) method was applied to stratify results into tiers. Score distributions across tiers are reported descriptively.

A total of 26 resident physicians from 12 residency training bases were included in the evaluation. The excellent tier comprised residents from neurosurgery and cardiothoracic surgery. C_i values showed a clear ascending gradient across RSR tiers, with higher tiers corresponding to greater DRG case complexity and higher DRG weights.

This pilot study demonstrates the feasibility of a DRG-based weighted TOPSIS-RSR model for evaluating the clinical practice performance of resident physicians during their hospital-based training, and does not serve as a comprehensive assessment of clinical competence. Before being used in high-stakes decision-making, it must be externally validated against established competency assessment tools.