BackgroundFrameworks like the CanMEDS model depicting professional roles and specific professional activities provide guidelines for postgraduate education. When medical graduates start their residency, they should possess certain competencies related to communication, management and professionalism while other competencies will be refined during postgraduate training. Our study aimed to evaluate the relevance of different competencies for a first year resident required for entrustment decision from the perspective of physicians from medical faculties with different undergraduate medical curricula.MethodsNine hundred fifty-two surgeons and internists from three medical schools with different undergraduate medical curricula were invited to rank 25 competencies according to their relevance for first year residents. The rankings were compared between universities, specialties, physicians’ positions, and gender.ResultsTwo hundred two physicians participated, 76 from Hamburg University, 44 from Oldenburg University, and 82 from Technical University Munich. No significant differences were found regarding the top 10 competencies relevant for first year residents between the universities. ‘Responsibility’ was the competency with the highest rank overall. Internists ranked ‘Structure, work planning and priorities’ higher while surgeons ranked ‘Verbal communication with colleagues and supervisors’ higher. Consultants evaluated ‘Active listening to patients’ more important than department directors and residents. Female physicians ranked ‘Verbal communication with colleagues and supervisors’ and ‘Structure, work planning and priorities’ significantly higher while male physicians ranked ‘Scientifically and empirically grounded method of working’ significantly higher.ConclusionsPhysicians from universities with different undergraduate curricula principally agreed on the competencies relevant for first year residents. Some differences between physicians from different positions, specialties, and gender were found. These differences should be taken into account when planning competence-based postgraduate education training programs.

Background: Assessing competence of advanced undergraduate medical students based on performance in the clinical context is the ultimate, yet challenging goal for medical educators to provide constructive alignment between undergraduate medical training and professional work of physicians. Therefore, we designed and validated a performance-based 360-degree assessment for competences of advanced undergraduate medical students. Methods: This study was conducted in three steps: 1) Ten facets of competence considered to be most important for beginning residents were determined by a ranking study with 102 internists and 100 surgeons. 2) Based on these facets of competence we developed a 360-degree assessment simulating a first day of residency. Advanced undergraduate medical students (year 5 and 6) participated in the physician's role. Additionally knowledge was assessed by a multiple-choice test. The assessment was performed twice (t 1 and t 2 ) and included three phases: a consultation hour, a patient management phase, and a patient handover. Sixty-seven (t 1 ) and eighty-nine (t 2 ) undergraduate medical students participated. 3) The participants completed the Group Assessment of Performance (GAP)-test for flight school applicants to assess medical students' facets of competence in a non-medical context for validation purposes. We aimed to provide a validity argument for our newly designed assessment based on Messick's six aspects of validation: (1) content validity, (2) substantive/cognitive validity, (3) structural validity, (4) generalizability, (5) external validity, and (6) consequential validity. Results: Our assessment proved to be well operationalised to enable undergraduate medical students to show their competences in performance on the higher levels of Bloom's taxonomy. Its generalisability was underscored by its authenticity in respect of workplace reality and its underlying facets of competence relevant for beginning residents. The moderate concordance with facets of competence of the validated GAP-test provides arguments of convergent validity for our assessment. Since five aspects of Messick's validation approach could be defended, our competence-based 360-degree assessment format shows good arguments for its validity. Conclusion: According to these validation arguments, our assessment instrument seems to be a good option to assess competence in advanced undergraduate medical students in a summative or formative way. Developments towards assessment of postgraduate medical trainees should be explored.

BackgroundPhysicians need a set of specific competences to perform well in interprofessional teams in their first year of residency. These competences should be achieved with graduation from medical school. Assessments during undergraduate medical studies are mostly rated by supervisors only. The aim of our study was to compare the rating of core facets of competence of medical students late in their undergraduate training as well as the rating confidence between three different groups of assessors (supervisors, residents, and nurses) in an assessment simulating the first day of residency.MethodsSixty-seven advanced medical students from three different medical schools (Hamburg, Oldenburg and Munich) participated in a 360-degree assessment simulating the first working day of a resident. Each participant was rated by three assessors – a supervisor, a resident and a nurse – in seven facets of competence relevant for the first year of residency: (1) responsibility, (2) teamwork and collegiality, (3) knowing and maintaining own personal bounds and possibilities, (4) structure, work planning and priorities, (5) coping with mistakes, (6) scientifically and empirically grounded method of working, and (7) verbal communication with colleagues and supervisors. Means of all assessed competences and confidences of judgement of the three rating groups were compared. Additionally, correlations between assessed competences and confidence of judgement within each group of raters were computed.ResultsAll rating groups showed consistent assessment decisions (Cronbach’s α: supervisors = .90, residents = .80, nurses = .78). Nurses assessed the participants significantly higher in all competences compared to supervisors and residents (all p ≤ .05) with moderate and high effect sizes (d = .667–1.068). While supervisors’ and residents’ ratings were highest for “teamwork and collegiality”, participants received the highest rating by nurses for “responsibility”. Competences assessed by nurses were strongly positively correlated with their confidence of judgment while supervisors’ assessments correlated only moderately with their confidence of judgment in two competences.ConclusionsDifferent professional perspectives provide differentiated competence ratings for medical students in the role of a beginning resident. Rating confidence should be enhanced by empirically derived behavior checklists with anchors, which need to be included in rater training to decrease raters’ subjectivity.Electronic supplementary materialThe online version of this article (10.1186/s12909-019-1473-6) contains supplementary material, which is available to authorized users.