Measuring service-specific performance and educational value within a general surgery residency: The power of a prospective, anonymous, Web-based rotation evaluation system in the optimization of resident satisfaction

Background. We used a Web-based evaluation system to institute specific cha nges to various clinical teaching services in our integrated residency in a n effort to optimize the overall quality of the educational experience and measured the resident satisfaction in these rotations. Methods. Residents rated 8 categories of experience on a scale of 1 to 5 (m aximum summation score, 40 points). Data were analyzed by t-test for equali ty of means. A probability value of less than .05 was considered significan t. Results. Compliance with completion of the evaluations was 100%. The Chronb ach's alpha reliability coefficient of the tool was 0.826. Tukey's estimate of power to achieve additivity was 1.5. Six under-performing services were re-engineered with prominent effects on 7 postgraduate year (PGI) rotation s. Oil 2 general surgery services at 1 hospital, the workload was redistrib uted, and a dedicated team teaching time was instituted (PGY-3 [a]: before, 22 points/after, 31 points; P = .003; PGY-3 [b]: before, 25 points/after; 31 points; = .004; PGY-1: before, 24 points/after, 29 points; P = .07). A g eneral surgery service at an other hospital redistributed coverage of the a ttending surgeons to create a nonteaching set-vice (PGY-1: before, 22 point s/-after, 27 points; P = .01). The transplantation set-vice (PGY-3) was exa mined, and the role of the point was redefined (before, 24 points/after, 31 points; P = .01). One vascular service (PGY-2) redistributed cases and wor kload (before, 27 points/after; 22 paints; P = .07). The vascular PGY-2 pos ition was eliminated and replaced 1, a mid-level practitioner The cardiotho racic service (PGY-1) rotation was converted into a preceptorship (before, 23 points/after, 30 points; P = .015). Conclusions. A web-based clinical rotation evaluation provides a means for the assessment of the impact of programmatic changes while preserving resid ent anonymity and maintaining accountability.