The state of evaluation in internal medicine residency.

BACKGROUND

There are no nationwide data on the methods residency programs are using to assess trainee competence. The Accreditation Council for Graduate Medical Education (ACGME) has recommended tools that programs can use to evaluate their trainees. It is unknown if programs are adhering to these recommendations.

OBJECTIVE

To describe evaluation methods used by our nation's internal medicine residency programs and assess adherence to ACGME methodological recommendations for evaluation.

DESIGN

Nationwide survey.

PARTICIPANTS

All internal medicine programs registered with the Association of Program Directors of Internal Medicine (APDIM).

MEASUREMENTS

Descriptive statistics of programs and tools used to evaluate competence; compliance with ACGME recommended evaluative methods.

RESULTS

The response rate was 70%. Programs were using an average of 4.2-6.0 tools to evaluate their trainees with heavy reliance on rating forms. Direct observation and practice and data-based tools were used much less frequently. Most programs were using at least 1 of the Accreditation Council for Graduate Medical Education (ACGME)'s "most desirable" methods of evaluation for all 6 measures of trainee competence. These programs had higher support staff to resident ratios than programs using less desirable evaluative methods.

CONCLUSIONS

Residency programs are using a large number and variety of tools for evaluating the competence of their trainees. Most are complying with ACGME recommended methods of evaluation especially if the support staff to resident ratio is high.