Identification of high-risk residents

Patricia C Bergen, J. H. Littlefield, G. E. O'Keefe, Robert V Rege, T. A. Anthony, L. T. Kim, R. H. Turnage

Research output: Contribution to journalArticle

29 Scopus citations

Abstract

Background. Identification of high-risk residents allows remediation and support for administrative action when necessary. This study characterizes differences in documentation of marginally performing residents in a general surgery residency. Methods. High-risk residents were identified by the former program director. Twenty-four of one hundred fifteen residents over a 10-year period had one to four problematic areas: cognitive, synthetic, family/health, and interpersonal skills. Outcomes included finished (18), voluntary withdrawal (1), and involuntary withdrawal (5). A case-control study matching controls to cases by date of entry into the training program was used. Records were reviewed for demographics, preentry qualifications, American Board of Surgery In-Training Exam (ABSITE) scores, letters of complaint or praise, events of counseling, and monthly ratings. The records of 48 residents were reviewed. Ward evaluations were on eight categories with a 5-point Leikert scale (3 - unacceptable to 7 - outstanding). The evaluation score assigns points only to low ratings. High scores represent progressively poorer performance. A Wilcoxon signed ranks test was used to compare the cases and controls for continuous variables. The McNemar test was used in comparisons of categorical data with binary outcomes. Exact P values are reported. Results. Objective data were similar for both groups. Study residents tended to score higher on monthly evaluations at Year 2 and by Year 3 this achieved significance (0.026). Study residents were more likely to have negative faculty letters (0.016) and events of counseling by a faculty member (0.017) and the program director (0.005). Conclusions. Identification of residents at risk should begin as early as possible during training. A combination of faculty evaluations and evidence of letters of counseling can detect high-risk residents. Programs may use such indicators to support decisions regarding remedial work or administrative action. (C) 2000 Academic Press.

Original languageEnglish (US)
Article number95924
Pages (from-to)239-244
Number of pages6
JournalJournal of Surgical Research
Volume92
Issue number2
DOIs
StatePublished - Jan 1 2000

Keywords

  • Evaluation
  • Performance
  • Surgical education

ASJC Scopus subject areas

  • Surgery

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    Bergen, P. C., Littlefield, J. H., O'Keefe, G. E., Rege, R. V., Anthony, T. A., Kim, L. T., & Turnage, R. H. (2000). Identification of high-risk residents. Journal of Surgical Research, 92(2), 239-244. [95924]. https://doi.org/10.1006/jsre.2000.5924