Content Analysis of Family Medicine Resident Peer Observations

Abstract

Background and Objectives: Direct observation is a critical part of assessing learners’ achievement of the Accreditation Council for Graduate Medical Education (ACGME) Milestones and subcompetencies. Little research exists identifying the content of peer feedback among residents; this study explored the content of residents’ peer assessments as they relate to ACGME Milestone subcompetencies in a family medicine residency program. Methods: Using content from a mobile app-based observation tool (M3App), we examined resident peer observations recorded between June 2014 and November 2017, tabulating frequency of observation for each ACGME subcompetency and calculating the proportion of observations categorized under each subcompetency, as well as for each postgraduate year (PGY) class. We also coded each observation on three separate dimensions: “positive,” “constructive,” and “actionable.” We used the χ2 test for independence, and estimated odds ratios and 95% confidence intervals for two-by-two comparisons to compare numbers of observations within each category. Results: Our data include 886 peer observations made by 54 individual residents. The most frequently observed competencies were in patient care, communication, and professionalism (56%, 47%, and 38% of observations, respectively). Practice-based learning and improvement was observed least frequently (16% of observations). On average, 97.25% of the observations were positive, 85% were actionable, and 6% were constructive. Conclusions: When asked to review their peers, residents provide comments that are primarily positive and actionable. In addition, residents tend to provide more feedback on certain subcompetencies compared to others, suggesting that programs may rely on peer feedback for specific subcompetencies. Peers can provide perspective on the behaviors and skills of fellow residents.

Preparing residents to practice integrated behavioral health care: Multi-site feasibility study of a competency-based curriculum

“…Residents benefit from direct observation and feedback about communication, BH, and family systems skills. [23][24][25] We acknowledge limitations of the program and our evaluation. First, our curriculum may not meet the BH training needs for all family medicine residencies across the United States.…”

“…Residents benefit from direct observation and feedback about communication, BH, and family systems skills. 23–25…”

“…Like other findings on BH knowledge and skill acquisition, residents who report competence in BH skills may not have high-levels of confidence in being able to apply these skills over time. 24,25 Third, less than half of residents (46%; n = 19) at participating programs completed both pre- and post-training surveys. This low response rate is likely due to the voluntary nature of the survey and the busy schedules that residents often follow.…”