The challenge and importance of evaluating residents and fellows debra weinstein m d
Download
1 / 15

The Challenge and Importance of Evaluating Residents and Fellows Debra Weinstein, M.D. - PowerPoint PPT Presentation


  • 89 Views
  • Uploaded on

The Challenge and Importance of Evaluating Residents and Fellows Debra Weinstein, M.D. PHS GME Coordinators Retreat March 25, 2011. What keeps us up at night?. Recruiting top candidates Protecting time for education Duty hours compliance

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about 'The Challenge and Importance of Evaluating Residents and Fellows Debra Weinstein, M.D.' - helia


An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
The challenge and importance of evaluating residents and fellows debra weinstein m d

The Challenge and Importance of Evaluating Residents and FellowsDebra Weinstein, M.D.

PHS GME Coordinators Retreat

March 25, 2011


What keeps us up at night
What keeps us up at night? Fellows

  • Recruiting top candidates

  • Protecting time for education

  • Duty hours compliance

  • Evaluating residents; providing feedback; dealing with poor performance


Why is this so important
Why is this so important? Fellows

  • Duty to trainees

    • promote professional development

    • help each reach his/her greatest potential

  • Duty to society

    • ensure minimum standards of competence

    • promote development of accurate self-assessment, knowledge of individual limits


How do we know there s a gap
How do we know there’s a gap? Fellows

  • Internal reviews

  • ACGME resident survey

  • ACGME citations

  • Individual cases


Where are we falling short
Where are we falling short? Fellows

  • Many assigned evaluations are never done

  • Quality of evaluations is variable

    • Important questions not asked

    • Only ratings / no commentary

    • Intentional avoidance of critique

  • Evaluations not consistently reviewed with trainees

  • 360-degree evaluations not implemented


Goals
Goals Fellows

  • Protect current and future patients

    • Ensure appropriate balance of supervision and independence during training

    • Provide accurate references

    • Develop physician skills in self-assessment, understanding individual limits

  • Optimize professional development and satisfaction of individual trainees

    • Focus on exceptional talent and potential as well as weaknesses

    • Utilize performance reviews to individualize education and career counseling


Trainee assessment must be able to identify the spectrum of problems encountered
Trainee assessment must be able to identify the spectrum of problems encountered

  • Insufficient academic progress: knowledge, judgment, decision making

  • Insufficient technical skill

  • Poor professionalism: dishonest, irresponsible, poor work ethic, inappropriate behavior

  • Interpersonal conflicts

  • Substance abuse

  • Mental health issues

  • Learning disabilities; ADD

  • Other: poor organizational skills, carelessness, lack of productivity, etc.


Phs evaluation feedback task force key recommendations
PHS Evaluation/Feedback Task Force: problems encountered Key Recommendations

  • Stronger and more specific PHS policy

  • Steering Committee to oversee and champion the effort

  • Dedicated champion to implement and assess impact

  • Faculty development, resident/fellow training, improved infrastructure

  • Incentives/mandates for faculty


Faculty development initiatives
Faculty Development Initiatives problems encountered

Institution

  • ABIM Hospital Visit Program, May 2011

    Department

  • “Train the trainer” sessions

  • Grand rounds, retreats, new hire orientation

    Individual

  • 1:1 coaching, role play


Resident fellow training
Resident/Fellow Training problems encountered

  • shift in culture: seek, accept and utilized feedback

    • Formative, not punitive!

  • peer evaluation

  • self-evaluation


Osce objective structured clinical exam
OSCE problems encountered(Objective Structured Clinical Exam)

  • Objective: 1) Teaching 2) ?Early identification “at risk” trainees

  • Focus: Communication/interpersonal skills; patient safety

    • Plan:

      • 100 incoming intern participates during 2011 orientation program

      • Evaluate cost, feasibility, outcomes in considering future utilization


Targets for improved infrastructure
Targets for improved infrastructure problems encountered

  • Templates for 360-degree evaluations, can be customized by program

  • Automated compliance reports from web-based evaluation system

  • Electronic vehicle to immediately communicate a concern


How will we measure progress
How will we measure progress? problems encountered

  • Pre/post survey of faculty and trainees

    • knowledge, attitudes, confidence

  • Pre/post comparison of evaluation completion rates, and quality

  • Internal reviews and accreditation reports

  • Discussion with program directors, coordinators, trainees and faculty


Key elements of an improved assessment system
Key Elements of An Improved Assessment System problems encountered

  • Sufficient contact between trainees and faculty to allow for assessment

  • Consistent completion of high quality evaluations

  • Effective feedback to trainees

  • Early identification of performance problems with prompt intervention

  • Accessible resources for remediation


Coordinators role work with program director to define this
Coordinators’ Role: problems encounteredWork with Program Director to define this!

May include:

  • Address the need for faculty contact/continuity in scheduling

  • Monitor evaluation completion rates; address non-compliance

  • Help to design and implement plan for obtaining 360-degree evaluations

  • Utilize and customize evaluation templates

  • Help to ensure that residents understand the program’s system for assessment: how is this communicated?