Academic medicine : journal of the Association of American Medical Colleges
-
Medical caregivers are always telling stories because stories provide meaning to much of their working lives. Although there is surely an element of shock value in the stories that medical professionals choose to share, the compulsion to tell a story is largely motivated by the profound emotions kindled by the clinical experience. This impulse needs to be recognized by the profession, even nurtured. ⋯ Any story that might be damaging, hurtful, or embarrassing to a patient does not belong in the public sphere. Nevertheless, those in medicine need to recognize that the impulse to tell a story is innate in the human race, especially so in the caregiving professions. Experienced caregivers need to help students understand that stories provide depth and meaning to medicine but, when broadcast inappropriately, can cause harm.
-
Multicenter Study
Reviewing residents' competence: a qualitative study of the role of clinical competency committees in performance assessment.
Clinical competency committees (CCCs) are now required in graduate medical education. This study examined how residency programs understand and operationalize this mandate for resident performance review. ⋯ Institutions orient resident performance review toward problem identification; a developmental approach is uncommon. Clarifying the purpose of resident performance review and employing efficient information systems that synthesize performance data and engage residents and faculty in purposeful feedback discussions could enable the meaningful implementation of milestones-based assessment.
-
Residency programs around the world use multisource feedback (MSF) to evaluate learners' performance. Studies of the reliability of MSF show mixed results. This study aimed to identify the reliability of MSF as practiced across occasions with varying numbers of assessors from different professional groups (physicians and nonphysicians) and the effect on the reliability of the assessment for different competencies when completed by both groups. ⋯ A feasible number of assessors per MSF occasion can reliably assess residents' performance. Scores from a single occasion should be interpreted cautiously. However, every occasion can provide valuable feedback for learning. This research confirms that the (unique) characteristics of different assessor groups should be considered when interpreting MSF results. Reliability seems to be influenced by the included assessor groups and competencies. These findings will enhance the utility of MSF during residency training.