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Related Experiment Videos

Ward evaluations: should they be abandoned?

C J Kwolek1, M B Donnelly, D A Sloan

  • 1Department of Surgery, University of Kentucky, Lexington 40536-0084, USA.

The Journal of Surgical Research
|April 1, 1997
PubMed
Summary

Faculty ward evaluations (WE) are reliable for assessing residents overall clinical competence and correlate with objective structured clinical examinations (OSCE), but lack skill differentiation.

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Area of Science:

  • Medical Education
  • Clinical Competence Assessment
  • Surgical Residency Training

Background:

  • Faculty ward evaluations (WE) remain the primary method for assessing resident performance, despite concerns regarding reliability.
  • The objective structured clinical examination (OSCE) is an alternative assessment tool, but WE continues to dominate resident evaluation.

Purpose of the Study:

  • To evaluate the reliability and validity of faculty ward evaluations (WE) as a measure of clinical competence in surgical residents.
  • To determine if WE can accurately differentiate resident performance levels and identify specific skill deficiencies.

Main Methods:

  • A one-year study involving 72 surgery residents evaluated by an average of 7 faculty members using a 10-item performance rating form.
  • Inter-rater reliability was assessed using intraclass correlation, and validity was examined through discriminant function analysis, correlation with OSCE scores, and factor analysis.

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Main Results:

  • High inter-rater reliability (0.82) for overall performance ratings was observed, but single-rater reliability was lower (0.39).
  • Ward evaluations differentiated residents by training level (P < 0.0001) and correlated significantly with concurrent OSCE scores (r = 0.55, P < 0.0001).
  • Factor analysis revealed a global, undifferentiated judgment, with ratings insensitive to performance deficiencies (only 1.3% unsatisfactory/marginal).

Conclusions:

  • Ward evaluations provide a reliable estimate of faculty perception of resident performance and demonstrate validity through differentiation by training level and correlation with OSCEs.
  • However, WE lacks the ability to discriminate between specific skills and fails to identify deficient performance, suggesting a global assessment rather than skill-specific feedback.
  • Despite limitations, WE retains a valuable role in the comprehensive assessment of residents within surgical training programs.