13 Truths Our People

There's a better way
to evaluate residents

There's a better way to evaluate residents

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"She's a great doctor." The attending circles the number five on the resident's evaluation card.

This tells us what, exactly? That she's ready to advance to her fellowship? That anyone can entrust her with their children? That she should continue to be "great"?

We have come a long way from believing that physicians only need to be experts in anatomy; we expect that they communicate well, have excellent bedside manner, and actively prevent errors.

So how do you determine whether or not residents are becoming well-rounded, competent caregivers?

Most residency programs in the United States use an evaluation system with a number scale linked to descriptions of competencies. But the process of translating observations into the language of the evaluation form is difficult and time-consuming. And this system doesn't leave room for faculty to record or share specific observations and judgments, and that is a missed learning opportunity for residents.

Lindsey Lane, BMBCh, Vice Chair of Education in the Department of Pediatrics at Children's Colorado, along with Janice Hanson, Ph.D., and Adam Rosenberg, M.D., have pioneered what may be the first resident evaluation system of its kind. Instead of using numbers, their method has faculty write rich narrative descriptions of each resident's actions, with suggestions for improvement.

Narratives help us understand who people really are. That, Dr. Lane surmises, is the kind of evaluation that will help us better understand who our doctors-in-training really are. Instead of the one-dimensional "she's a great doctor and I give her a five," an attending at Children's Colorado, for example, might write something like this:

"The mother of a patient with epilepsy was highly stressed and our clinic was very busy. The resident sat with the mother and talked with her patiently and effectively until she calmed down. This allowed me to continue seeing patients and kept the clinic running smoothly."

Collectively, these hundreds of narratives paint a vivid picture of each resident, a sort of pointillism approach to evaluations. This not only makes for more accurate evaluations, it shows residents which behaviors they do well and which need improvement.

It could be the start of an entirely new learning experience.

Want to learn more about what's going on in the Department of Pediatrics at the University of Colorado School of Medicine? Check out pediatrics.ucdenver.edu.

In August 2013, Dr. Lane and her colleagues from the Medical Education department at Children's Colorado presented their work at the international conference of the Association for Medical Education in Europe, in Prague.

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