ASSESSING SENIOR RESIDENTS KNOWLEDGE AND PERFORMANCE - AN INTEGRATED EVALUATION PROGRAM

Background. Surgical residents have traditionally been evaluated by wa rd evaluations and multiple-choice testing; overall resident,performan ce has seldom been objectively evaluated. We developed a comprehensive evaluation program for senior residents. The purpose of this study wa s to determine whether the several different assessment methods includ ed in this program provide similar information about senior residents' clinical knowledge and performance. Methods. Sixteen senior general s urgery residents were evaluated by subjective faculty ward evaluations , a structured oral examination the American Board of Surgery In-Train ing Examination, and an objective structured clinical examination (OSC E). The OSCE was divided into two parts: part A required the resident to obtain a directed history or to perform a physical examination; par t B required the resident to answer questions about the patient seen i n part A. Results. The various evaluation methods differed in their es timates of clinical competence (ward evaluations rated residents highe st; the OSCE, lowest). The American Board of Surgery In-Training Exami nation correlated with both the structured oral examination and OSCE p art B, indicating that all are adequate measures of knowledge. Neither the total OSCE scare nor OSCE part A correlated with other measures, but the fact that both are highly reliable suggests that they evaluate different clinical skills. Faculty ward evaluations are inflated and do not correlate with other measures. Conclusions. We conclude that de veloping a comprehensive program for evaluating resident competence is desirable and feasible.