An evaluation system for residency training

The authors distinguish between systematic and episodic methods of educational evaluation and review the numerous pressures necessitating incorporation of evaluation systems into house-staff training programs. Such pressures include needs to document quality and quantity of training experiences, often mandated by external agencies, as well as trainee desire for increased feedback to guide their personal development. In response, a house-staff evaluation model based on principles of participative decision making and collegial information sharing was developed and implemented at the University of North Carolina. The model features use of multiple and interacting sources of information about each resident and structured occasion for that information to be discussed in the resident's presence. This process leads to carefully documented decisions about strengths and weaknesses of each resident and about the program itself. Evaluation systems are beneficial to the degree that their design matches the organizational climate of the program they serve, and to the degree that they can evolve as the program evolves to maintain such goodness-of-fit.