An Ounce of Prevention: How Are We Managing the Early Assessment of Residents' Clinical Skills?: A CERA Study
Authors
Kedian, TracyGussak, Lisa S.
Savageau, Judith A.
Cohrssen, Andreas
Abramson, Ilene
Everard, Kelly
Dobbie, Alison
UMass Chan Affiliations
Center for Health Policy and ResearchDepartment of Family Medicine and Community Health
Document Type
Journal ArticlePublication Date
2012-11-14Keywords
Internship and ResidencyClinical Competence
Medical Education
Preventive Medicine
Primary Care
Metadata
Show full item recordAbstract
BACKGROUND AND OBJECTIVES: Clinical skills deficits in residents are common but when identified early can result in decreased cost, faculty time, and stress related to remediation. There is currently no accepted best practice for early assessment of incoming residents' clinical skills. This study describes the current state of early PGY-1 clinical skills assessment in US family medicine residencies. METHODS: Eleven questions were embedded in the nationwide CERA survey to US family medicine residency directors regarding the processes, components, and barriers to early PGY-1 assessment. Responses are described, and bivariate analyses of the relationship between assessment variables and percentage of international medical graduates (IMGs), type of program, and barriers to implementation were performed using chi square testing. RESULTS: Almost four of five (78.4%) responding programs conduct formal early assessments to establish baseline clinical skills (89.6%), provide PGY-1 residents with a guide to focus their learning goals (71.6%), and less often, in response to resident performance problems (34.3%). Barriers to implementing PGY-1 early assessment programs include cost of faculty time (56.3%), cost of tools (42.1%), and time for the assessment during the PGY-1 resident's schedule (41.0%). Cost of faculty time and time for assessment from the PGY-1 resident's schedule were statistically significant major/insurmountable barriers for community-based, non-university-affiliated programs. CONCLUSIONS: Early PGY-1 assessments with locally developed tools for direct observation are commonly used in family medicine residency programs. Assessment program development should be targeted toward using existing, validated tools during the PGY-1 resident's patient care schedule.Source
Fam Med. 2012 Nov;44(10):723-6. Link to article on publisher's website