Educating the Pediatrician of the 21st Century: Defining and Implementing a Competency-Based System

Carraccio, Carol; Englander, Robert; Wolfsthal, Susan D.; Martin, Christine; Ferentz, Kevin S.

doi:10.1542/peds.113.2.252

Cited by 65 publications

(43 citation statements)

References 11 publications

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“…These evaluations are limited for 2 reasons: often, faculty have not directly observed residents as they interact with patients and families, 3,4 and faculty evaluations do not consider other perspectives from nurses, patients, or residents' self-evaluation of their skills. The ACGME has suggested the use of multisource feedback and 360-degree evaluation systems as 1 method, using multiple evaluators for assessing resident skills in a variety of areas including professionalism and interpersonal and communication skills.…”

Section: Resultsmentioning

confidence: 99%

Use of a 360-Degree Evaluation in the Outpatient Setting: The Usefulness of Nurse, Faculty, Patient/Family, and Resident Self-Evaluation

Chandler¹,

Henderson²,

Park³

et al. 2010

Journal of Graduate Medical Education

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Background Faculty have traditionally evaluated resident physician professionalism and interpersonal skills without input from patients, family members, nurses, or the residents themselves. The objective of our study was to use “360-degree evaluations,” as suggested by the Accreditation Council for Graduate Medical Education (ACGME), to determine if nonfaculty ratings of resident professionalism and interpersonal skills differ from faculty ratings. Methods Pediatrics residents were enrolled in a hospital-based resident continuity clinic during a 5-week period. Patient/families (P/Fs), faculty (MD [doctor of medicine]), nurses (RNs [registered nurses]), and residents themselves (self) completed evaluator-specific evaluations after each clinic session by using a validated 10-item questionnaire with a 5-point Likert scale. The average Likert score was tallied for each questionnaire. Mean Likert scale scores for each type of rater were compared by using analysis of variance, text with pair-wise comparisons when appropriate. Agreement between rater types was measured by using the Pearson correlation. Results A total of 823 evaluations were completed for 66 residents (total eligible residents, 69; 95% participation). All evaluators scored residents highly (mean Likert score range, 4.4 to 4.9). However, MDs and RNs scored residents higher than did P/Fs (mean scores: MD, 4.77, SD [standard deviation], 0.32; RN, 4.85, SD, 0.30; P/F, 4.53, SD, 0.96; P < .0001). MD and RN scores also were higher than residents' self-evaluation scores, but there was no difference between self-scores and P/F scores (average resident self-score, 4.44, SD, 0.43; P < .0001 compared to MD and RN; P = .19 compared to P/F). Correlation coefficients between all combinations of raters ranged from −0.21 to 0.21 and none were statistically significant. Conclusion Our study found high ratings for resident professionalism and interpersonal skills. However, different members of the health care team rated residents differently, and ratings are not correlated. Our results provide evidence for the potential value of 360-degree evaluations.

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Section: Resultsmentioning

confidence: 99%

Use of a 360-Degree Evaluation in the Outpatient Setting: The Usefulness of Nurse, Faculty, Patient/Family, and Resident Self-Evaluation

Chandler¹,

Henderson²,

Park³

et al. 2010

Journal of Graduate Medical Education

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“…Rarely do we validate their judgements. Recent studies in Canada (Lieberman & Hilliard 2006) and the US (Carraccio et al 2004;Lesky 2007) have reinforced the need for regular programme evaluations, more standardized mechanisms for monitoring the training-practice gaps and the need for sufficient specific training to enable paediatricians to competently investigate and manage a variety of conditions. Thus, there is a need for ongoing monitoring of competencies acquired during residency training and preparedness for practice.…”

Section: Practice Pointsmentioning

confidence: 99%

Validating objectives and training in Canadian paediatrics residency training programmes

2011

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“…5 In addition, delivery of effective and high-quality patientcentered care increasingly underscores cultural competence as a necessary professional skill. [6][7][8][9] Houpt et al 10 proposed that culturally competent care is required for the effective health care of immigrants and that learners need to have a basic understanding of the medical and social issues involved in the care of diverse patient populations.…”

Section: Introductionmentioning

confidence: 99%

Reflective Practice and Competencies in Global Health Training: Lesson for Serving Diverse Patient Populations

Castillo¹,

Goldenhar²,

Baker³

et al. 2010

Journal of Graduate Medical Education

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Background Resident interest in global health care training is growing and has been shown to have a positive effect on participants' clinical skills and cultural competency. In addition, it is associated with career choices in primary care, public health, and in the service of underserved populations. The purpose of this study was to explore, through reflective practice, how participation in a formal global health training program influences pediatric residents' perspectives when caring for diverse patient populations. Methods Thirteen pediatric and combined-program residents enrolled in a year-long Global Health Scholars Program at Cincinnati Children's Hospital Medical Center during the 2007–2008 academic year. Educational interventions included a written curriculum, a lecture series, one-on-one mentoring sessions, an experience abroad, and reflective journaling assignments. The American Society for Tropical Medicine and Hygiene global health competencies were used as an a priori coding framework to qualitatively analyze the reflective journal entries of the residents. Results Four themes emerged from the coded journal passages from all 13 residents: (1) the burden of global disease, as a heightened awareness of the diseases that affect humans worldwide; (2) immigrant/underserved health, reflected in a desire to apply lessons learned abroad at home to provide more culturally effective care to immigrant patients in the United States; (3) parenting, or observed parental, longing to assure that their children receive health care; and (4) humanitarianism, expressed as the desire to volunteer in future humanitarian health efforts in the United States and abroad. Conclusions Our findings suggest that participating in a global health training program helped residents begin to acquire competence in the American Society for Tropical Medicine and Hygiene competency domains. Such training also may strengthen residents' acquisition of professional skills, including the Accreditation Council for Graduate Medical Education competencies.

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Educating the Pediatrician of the 21st Century: Defining and Implementing a Competency-Based System

Cited by 65 publications

References 11 publications

Use of a 360-Degree Evaluation in the Outpatient Setting: The Usefulness of Nurse, Faculty, Patient/Family, and Resident Self-Evaluation

Use of a 360-Degree Evaluation in the Outpatient Setting: The Usefulness of Nurse, Faculty, Patient/Family, and Resident Self-Evaluation

Validating objectives and training in Canadian paediatrics residency training programmes

Reflective Practice and Competencies in Global Health Training: Lesson for Serving Diverse Patient Populations

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