Council on Medical Student Education in Pediatrics

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COMSEP 2010 Albuquerque Meeting

LEARNER ASSESSMENT OF RESIDENT PERFORMANCE

Authors:
Lavjay Butani, MD, Pediatrics; Debora Paterniti, PhD, Internal Medicine and Sociology; Su-Ting Li, MD, Pediatrics, University of California Davis, Sacramento, CA

 

Background: Residents are at the forefront of medical student education. However, their effectiveness has not been well studied, in part due to the lack of a valid tool to assess resident performance from the point of view of students. Objective: To develop a valid evaluation instrument for student assessment of residents as clinician role models and educators. Methods: Semi-structured focus groups with a purposeful sampling of important stakeholders at our institution. Focus groups explored qualities valued in a resident as a clinician role-model and as an educator. Transcripts of interviews were iteratively reviewed for an exhaustive list of attributes and recurring themes.   Results: Preliminary findings from 3 sets of stakeholders: pediatric residents (n=9), 4th year medical students (n=10), and pre-and post pediatric clerkship 3rd year medical students (n=12) are presented. 13 key elements emerged, which were categorized into 3 themes: interpersonal attributes, patient care skills, and teaching strategies. 5 elements pertained to interpersonal attributes: professionalism (e.g., respectful), team dynamics (e.g., values learner as colleague), communication skills (e.g., provides clear expectations), sensitivity (e.g., shows humility), and passion (e.g., enjoys patient care). Clinical competence was the single element under patient care skills. Under the rubric teaching attributes were 2 elements: feedback (e.g., gives timely feedback) and programmatic awareness (e.g., knows clerkship goals). 5 elements were applicable to both patient care and teaching: accountability (e.g., patient advocate, invested in learner’s success), addresses/assesses needs (e.g., addresses patient concerns, makes teaching relevant to learner), teaching style (e.g., uses shared decision-making, teaches through problem solving), critical thinking (e.g., is intellectually curious, asks appropriate questions), and organization (e.g., balances patient care and teaching). Discussion: 13 key elements pertaining to residents as clinicians and educators were identified by stakeholders. The 2 most frequently cited elements crossed themes and were: assesses/addresses needs & critical thinking skills. This overlap may make it challenging to separately evaluate resident attributes pertaining to patient care and teaching and emphasizes the need to incorporate elements related to both patient care competencies and teaching skills in residency training and in designing resident as teacher curricula.