training in a traditional operative setting is necessary to put the costs associated with building and maintaining skills laboratories in perspective. Cost analyses and efficacy of teaching will allow for us to rate the success of new educational techniques. Rubinfeld I, Haurani MJ, Musial JL, Rao S, Parker A, Reickert C, Raafat A, Shepard A. From the Henry Ford Hospital, Detroit, Michigan. Purpose: The ACGME's Outcomes Project requires the assessment of resident competency in 6 domains. A Likert-scale evaluation is frequently employed when measuring resident performance within these competencies. Ideally, these evaluations should be completed by trained observers in a standardized fashion to ensure internal validity and high inter-rater reliability. In reality, however, this ideal is not always possible and evaluators may be unduly influenced by resident affability [Interpersonal and Communication Skills (ICS)] and availability [Professionalism (PR)], thereby resulting in a halo effect. To determine whether the ICS and PR competencies influence and drive other competency scores, the following study was undertaken. Methods: General surgery resident evaluations are performed by staff and peers on a rotational basis using locally developed competency-based questions. Each question is scored using a 5-point Likert scale. Mean individual composite scores for each competency were calculated and then correlated with other mean composite competency scores. A similar comparison was carried out using evaluations of ICS and PR performed by patients. A final correlation of competency scores to ABSITE scores, as an objective, standardized measure of a specific competency [Medical Knowledge (MK)], was also performed. Analysis was completed using SPSS, v 14.0 (SPSS Corporation, Chicago, Illinois). The Pearson correlation coefficient was employed and statistical significance was set at p Յ 0.05. Results: Results were available for 37 residents (PGY 1-5). A significant association existed between ICS scores and higher scores in MK (r ϭ 0.52, p ϭ 0.004), PR (r ϭ .826, p Ͻ 0.0001), and Patient Care (PC) (r ϭ 0.619, p Ͻ 0.0001). However, no correlation existed between patient evaluations of residents and their faculty/peer-based ICS scores. No association was found between ICS scores and improved patient evaluations. Lastly, no association was found between ICS or MK scores and ABSITE scores. Are the communication and professionalism competencies the new critical values in a resident's global evaluation process? Conclusions:The ICS scores correlated with higher scores in other competencies. It was difficult to ascertain whether residents with better ICS scores had higher PR, PC, and MK because of the halo effect, improper completion of evaluations, or whether those residents were truly performing better clinically. External measures of resident performance, including patient evaluations (ICS and PR) and ABSITE scores (MK), did not correlate with faculty/peer evaluations of ICS and PR. These results strengthen the argument that ...
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