Tell me a story about your trainee. Using "Standardized Narratives" to Explore New Ways to Represent Faculty Opinions in Resident Performance Regehr G et al. Academic Medicine 2012;87:419-427.
Reviewed by Jean A. Petershack
What was the study purpose?
This study looked at whether "standard narratives", or descriptions, of residents could be of value in assessing residents.
How was the study done?
Internists from two Canadian medical schools - McMaster University and University of Toronto - were asked to describe three different residents with whom they had worked: an outstanding resident, a problematic resident and an average resident. From these interviews, the authors created 16 standardized profiles of residents. These profiles were reviewed by four groups of experienced faculty from McMaster, UofT and the University of British Columbia. Faculty read, categorized and ranked the profiles from best to worst resident as individuals and as teams.
What were the results?
The narratives rang true to experienced faculty from three different sites that reportedly have different cultures. The ranking and categorizing of profiles was remarkably consistent with high intergroup reliability. Faculty showed consistency in what describes an excellent, problematic, or average resident in standardized narratives.
What are the implications of these findings?
The authors wonder if use of standardized narratives may be more consistent than currently used methods of assessment that deconstruct a resident's performance into the six ACGME competencies or seven CanMEDS domains. Many questions remain … How will these compare to our current methods? How can these narratives be used in common practice? Are narratives different for different specialties?
Editor's note: When we talk about an outstanding trainee, we usually tell a story about that individual. Rarely, do we launch into a discussion of his or her value in each of six or seven domains. This article challenges us to assess students in the same sort of way - to think of the entire picture of the resident and not "break down" the resident into the competency parts. It will be very interesting to see the future work that this group does in this realm. The 16 resident profiles can be accessed at http://links.lww.com/ACADMED/A77. (SLB)