METHODS USED IN THE EVALUATION OF CLINICAL COMPETENCE OF PHYSICAL MEDICINE AND REHABILITATION RESIDENTS

A 17-item questionnaire was designed to determine how physical medicin e and rehabilitation (PM&R) training directors assess their residents' clinical competency. A response rate of 83% (62/75) was obtained. Sev enty-nine percent (49/62) have a written resident supervision policy, and 73% (45/62) have a written resident probation policy. Ninety-four percent (58/62) believe that their system of evaluating residents' cli nical competency is effective, although many commented that it could b e improved. 76% (47/62) of the residency training directors made the f inal decision regarding residents' clinical competency. Fifty-two perc ent (32/62) have a departmental written examination, and 23% (14/62) h ave formal oral examinations. Eighteen percent (11/62) use an objectiv e structured clinical examination (OSCE), 8% (5/62) use standardized p atients and 3% (2/62) use videotaped patient encounters. Forty percent (25/62) use medical record audits. Fifty percent of the programs have rated at least one resident unsatisfactory during a clinical rotation in the past 3 yr, and 11% (7/62) have reported to the American Board of Physical Medicine and Rehabilitation that the overall clinical eval uation of one resident was unsatisfactory in the past 3 yr. Forty-seve n percent (29/62) of the programs have asked at least one resident to leave their program in the past 3 yr. The OSCE is emerging as the stat e-of-the-art method for assessing clinical skills, although it is expe nsive. The measurement of clinical competency is important in the cert ification and recertification process, and our specialty needs better methods to assess these performance skills.