Time in Continuity Clinic as a Predictor of Continuity of Care for Pediatric Residents

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.

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

“…25,26 PHY is the percentage of visits in which residents see their own patients. Thus, PHY reflects continuity from the perspective of the provider and is appropriate for evaluating the educational experience of residents.…”

Section: Workload and Continuity Variablesmentioning

confidence: 99%

Clinic Design, Key Practice Metrics, and Resident Satisfaction in Internal Medicine Continuity Clinics: Findings of the Educational Innovations Project Ambulatory Collaborative

Francis¹,

Thomas²,

Langan³

et al. 2014

“…6,8 Despite its importance, studies documenting resident continuity with patients generally illustrate disappointing findings. [18][19][20][21] One study found that pediatrics patients assigned to a resident physician saw their primary physician at only 25% of their visits. 22 Although past studies have demonstrated varied levels of continuity in resident teaching practices, factors that may improve continuity have not been evaluated.…”

Section: Introductionmentioning

confidence: 99%

Factors Associated With Resident Continuity in Ambulatory Training Practices

Fortuna¹,

Garfunkel²,

Mendoza³

et al. 2016