• Maura E Sullivan, Yoon Soo Park, Kathy Liscum, Ajit K Sachdeva, Patrice Gabler Blair, Melissa Gesbeck, and Georges Bordage.
• Department of Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA.
• Ann. Surg. 2020 Jul 1; 272 (1): 194-198.

ObjectiveTo assess the readiness of entering residents for clinical responsibilities, the American College of Surgeons (ACS) Division of Education developed the "Entering Resident Readiness Assessment" (ACS-ERRA) Program.Summary BackgroundACS-ERRA is an online formative assessment that uses a key features approach to measure clinical decision-making skills and focuses on cases encountered at the beginning of residency. Results can be used to develop learning plans to address areas that may need reinforcement.MethodsA national panel of 16 content experts, 3 medical educators, and a psychometrician developed 98 short, key features cases. Each case required medical knowledge to be applied appropriately at challenging decision points during case management. Four pilot testing studies were conducted sequentially to gather validity evidence.ResultsResidents from programs across the United States participated in the studies (n = 58, 20, 87, 154, respectively). Results from the pilot studies enabled improvements after each pilot test. For the psychometric pilot (final pilot test), 2 parallel test forms of the ACS-ERRA were administered, each containing 40 cases, resulting in overall mean testing time of 2 hours 2 minutes (SD = 43 min). The mean test score was 61% (SD = 9%) and the G-coefficient reliability was 0.90.ConclusionsResults can be used to identify strengths and weaknesses in residents' decision-making skills and yield valuable information to create individualized learning plans. The data can also support efforts directed at the transition into residency training and inform discussions about levels of supervision. In addition, surgery program directors can use the aggregate test results to make curricular changes.

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