The Importance of Measuring Competency-Based Outcomes: Standard Evaluation Measures Are Not Surrogates for Clinical Performance of Internal Medicine Residents

2009 ◽  
Vol 21 (2) ◽  
pp. 87-93 ◽  
Author(s):  
Lisa L. Willett ◽  
Gustavo R. Heudebert ◽  
Katri P. Palonen ◽  
F. Stanford Massie ◽  
Catarina I. Kiefe ◽  
...  
2011 ◽  
Vol 26 (3) ◽  
pp. 436-443 ◽  
Author(s):  
Douglas D. Ross ◽  
Deborah W. Shpritz ◽  
Susan D. Wolfsthal ◽  
Ann B. Zimrin ◽  
Timothy J. Keay ◽  
...  

2021 ◽  
Author(s):  
Andrew James Caddell ◽  
Edwin Moses Bamwoya ◽  
Andrew Donald Moeller

Abstract Background There has been a paradigm shift in residency training over the last several years wherein Competency by Design (CBD) is being integrated to replace more traditional time-based models of training. The Residency Program Committee (RPC) for the Cardiology training program at Dalhousie University in Halifax, Canada addressed the Transition to Practice stage by approving a trial of adjusting the resident call responsibilities to reflect the transition to CBD curriculum. The goal of this adjustment was three-fold: i. Gradually increase accountability of the senior cardiology resident as they transition to practice; ii. Address a gap in training that allows the senior resident to have a gradual transition to the role of a practicing cardiologist while on call; iii. Allows further evolution of skills and abilities. Methods A survey was administered to the practitioners involved in this competency-based change to the call responsibilities. Surveys were distributed to the final year Cardiology Residents, Staff Cardiologists, and Senior Internal Medicine residents to assess their experience and opinions of the current, competency-based change of the on-call curriculum. The survey consisted of eleven questions, of which, four were assessed on a Likert scale and 3 were yes/no questions. Results Four PGY6 cardiology residents, five senior internal medicine residents and eleven staff cardiologists completed the survey. Amongst those who completed the survey there was agreement that the change to the on-call responsibilities improved cardiology residents’ skills, accountability and preparedness to practice. All groups felt the changes were useful for the cardiology training program. There was mild negative effect of perceived accountability by the internal medicine residents. Conclusion Overall the change in call structure led to improved perceived preparedness to practice amongst the cardiology residents and addressed a gap in the Transition to Practice phase of CBD training. This study provides some evidence to the potential benefit of CBD and specifically in the benefits towards transitioning to practice.


2006 ◽  
Vol 6 (1) ◽  
Author(s):  
Balavenkatesh Kanna ◽  
Changchun Deng ◽  
Savil N Erickson ◽  
Jose A Valerio ◽  
Vihren Dimitrov ◽  
...  

2012 ◽  
Vol 3 (1) ◽  
pp. e21-e32
Author(s):  
René Wong

Background: Ambulatory training in internal medicine has been noted to be dysfunctional and inadequate. In this study, we developed a set of competency-based outcomes specific to ambulatory care to guide the design, implementation and evaluation of instructional events to ensure that societal needs are addressed. Methods: In 2007 a Delphi technique was used to reach consensus and define the priorities for competency-based training in ambulatory care for internal medicine residents. Four groups of stakeholders in Canada participated: program directors, members of the Canadian Society of Internal Medicine, recent graduates, and residents. Results: Two rounds of the Delphi process were required to reach consensus on a set of sixty competency-based educational objectives in ambulatory care that were classified under the CanMEDS roles. The inclusion of recent graduates in this study resulted in the addition of non-clinical topics that would have otherwise been missed, falling under roles historically viewed as being challenging to teach and evaluate (Manager, Health Advocate). Conclusion: This study is the first time a Delphi-process has been used to define the priorities for ambulatory care training in internal medicine under a competency-based framework. The resulting compendium of competency-based objectives provides a foundation from which educators can design, evaluate and modify existing training experiences.


2018 ◽  
Vol 9 (4) ◽  
pp. e59-68 ◽  
Author(s):  
Lia Daniels ◽  
Vijay Daniels

Background: Achievement goal theory is consistently associated with specific cognitions, emotions, and behaviours that support learning in many domains, but has not been examined in postgraduate medical education. The purpose of this research was to examine internal medicine residents’ achievement goals, and how these relate to their sense of self-efficacy, epistemic emotions, and valuing of formative compared to summative assessments. These outcomes will be important as programs transition more to competency based education that is characterized by ongoing formative assessments.                             Methods: Using a correlational design, we distributed a self-report questionnaire containing 49 items measuring achievement goals, self-efficacy, emotions, and response to assessments to internal medicine residents. We used Pearson correlations to examine associations between all variables.Results: Mastery-approach goals were positively associated with self-efficacy and curiosity and negatively correlated with frustration and anxiety. Mastery-approach goals were associated with a greater value for feedback derived from annual ACP exams, end-of-rotation written exams, and annual OSCEs. Performance-approach goals were only associated with valuing ACP exams.Conclusion: Mastery-approach goals were associated with self-efficacy and epistemic emotions among residents, two constructs that facilitate autonomous learning. Residents with mastery-approach goals also appeared to value a wider range of types of assessment data. This profile will likely be beneficial for learners in a competency-based environment that involves high levels of formative feedback.


Medical Care ◽  
1999 ◽  
Vol 37 (8) ◽  
pp. 773-784 ◽  
Author(s):  
Mitchell D. Wong ◽  
James P. Hollenberg ◽  
Mary E. Charlson

2014 ◽  
Vol 6 (2) ◽  
pp. 296-300 ◽  
Author(s):  
Rachael Cayce ◽  
Paul Bergstresser ◽  
Kathleen Hesterman ◽  
Daniel Condie

Abstract Background Physicians in specialties other than dermatology care for the majority of patients with skin diseases, yet most physicians receive little training in dermatology. Objectives The primary objective of this study was to determine whether there would be a sizable (20%) improvement in posttraining scores for internal medicine residents after completing 1 of 3 assigned curricula. A secondary objective was to determine whether there were significant differences in improvement among the 3 resident cohorts after completing their curriculum. Finally, we explored the residents' change in perceived clinical knowledge postcurriculum. Methods Thirty-six postgraduate year 2 internal medicine residents were randomized to complete 1 of 3 one-month dermatology curricula (didactic, clinical, or combined). The main outcome measure was performance on different sets of Medical Knowledge Self-Assessment Program (MKSAP)-15 questions at study entry and completion. A secondary outcome was self-rated performance in 3 clinical domains. Results All participants completed the study. All curricula led to an improvement in MKSAP-15 scores, but only students who completed the didactic curriculum demonstrated a 20% improvement in posttraining scores. A larger number of residents completing the clinical and didactic curricula rated their clinical performance as improved compared to those who completed the combined curriculum. Conclusions While all 3 curricula led to improvement, as measured by a standardized assessment, a didactic curriculum in dermatology resulted in the largest improvement in knowledge as measured by a multiple-choice test.


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