Leonard Michael S, Anson Elizabeth, Wakeman Derek, Robbins Brett, Boyce Irena P, Baecher Naz, McGregor Holly A
is a Professor, Departments of Pediatrics and Public Health Sciences, School of Medicine and Dentistry, and Chief Safety Officer, University of Rochester Medical Center, Rochester, New York, USA.
is an Assistant Professor, Harriet J. Kitzman Center for Research Support, School of Nursing, University of Rochester Medical Center, Rochester, New York, USA.
J Grad Med Educ. 2025 Apr;17(2):217-223. doi: 10.4300/JGME-D-24-00749.1. Epub 2025 Apr 15.
Medical schools and residency programs have increasingly established formal education and standardized curricula in patient safety and quality improvement. However, assessment of resident and fellow proficiency in these areas can be challenging. Our institution needed a tool with a broad scope of content and detailed competency levels. We therefore created the Rochester Improvement and Safety Education (RISE) Assessment. To describe the development, structure, and implementation of the RISE Assessment and provide preliminary validity evidence, including feasibility of use. The first axis of the tool consists of 4 domains divided into 8 subdomains and 52 content areas. The second axis utilizes a rubric, establishing consistent expectations for each proficiency level in an Accreditation Council for Graduate Medical Education Milestone-based format. A total of 1498 incoming and postgraduate year (PGY) 1-9 residents and fellows completed the RISE Assessment at least once between May 29, 2018, and August 30, 2022. This included incoming residents (N=418), PGY-1-4s (N=667), incoming fellows (N=120), and PGY-5-9s (N=293). Higher RISE scores were found for PGY-1-4s than incoming residents and for PGY-5-9s than incoming fellows. There was no difference in mean RISE scores between incoming fellows and PGY-1-4s. Analysis of a cohort of incoming residents (N=136) who completed the RISE Assessment upon starting their residency and then again at least 2 years later showed an increase in scores. Higher proficiency scores with increasing PGY levels and with assessments performed by the same residents over time provide validity evidence for the RISE Assessment.
医学院校和住院医师培训项目越来越多地在患者安全和质量改进方面建立了正规教育和标准化课程。然而，评估住院医师和研究员在这些领域的熟练程度可能具有挑战性。我们的机构需要一种涵盖广泛内容和详细能力水平的工具。因此，我们创建了罗切斯特改进与安全教育（RISE）评估。以描述RISE评估的开发、结构和实施情况，并提供初步的效度证据，包括使用的可行性。该工具的第一个轴由4个领域组成，分为8个子领域和52个内容领域。第二个轴使用了一个评分标准，以基于毕业后医学教育认证委员会里程碑的格式为每个熟练程度水平建立一致的期望。在2018年5月29日至2022年8月30日期间，共有1498名新入职和1-9年级的住院医师及研究员至少完成了一次RISE评估。这包括新入职住院医师（N=418）、1-4年级住院医师（N=667）、新入职研究员（N=120）和5-9年级住院医师（N=293）。发现1-4年级住院医师的RISE分数高于新入职住院医师，5-9年级住院医师的RISE分数高于新入职研究员。新入职研究员和1-4年级住院医师的平均RISE分数没有差异。对一组新入职住院医师（N=136）进行分析，他们在开始住院医师培训时完成了RISE评估，然后至少在2年后再次进行评估，结果显示分数有所提高。随着住院医师年级的增加以及同一住院医师随时间进行的评估，熟练程度分数越高，为RISE评估提供了效度证据。
