Evaluation Processes/Forms

Evaluation is a critical part of marking accomplishment and mastery of the skills and knowledge areas in this residency program. Pursuant thereto there are a variety of evaluations undertaken to document this mastery. Written examinations, evaluations of resident lectures, oral examinations and evaluation of clinical experience by both faculty and the residents are the components.

1. ABEM In-Service Examination - This exam is given in February of each year. It allows for individual and program comparison throughout the Emergency Medicine residencies in the United States. It is not a test to be taken lightly. This exam is MANDATORY. You will be excused from your rotation. Call the Residency Coordinator for test date for your calendar.

2. Oral Examinations

Oral examinations are administered once in the winter and again in the late spring of each year. These are MANDATORY. Your rotations will be contacted, you will be excused. These examinations are patterned very closely after both the format and content of the actual certifying oral examination process. The intent is to allow the faculty to evaluate resident thinking and performance "on their feet." It also provides the resident with content and format practice for the oral certification examination. This combination provides the faculty with another independent measure and evaluation of resident performance.

In the R-I year, each resident receives three 20 minute cases. In the R-II&R-III years, one 20 minute case and one 40 minute multiple case is presented. The residents are assessed by the criteria established by the American Board of Emergency Medicine which includes an eight-point scale for each of seven categories including data acquisition, problem-solving, patient management, health care provided, patient relations, clinical competence, and comprehension of pathophysiology. This scoring is limited to a group of critical and essential actions determined by the faculty in the care of the case. An overall score is given each case, shared with the resident, and included as part of the permanent record for review by the RRC. Questions or comments about the oral examination content and/or process should be directed to the Educational Coordinator. (See Section VI - specifics on preparation for oral examination.)

3. Resident Lectures

Residents provide a substantial amount of the educational material delivered in the didactic portion of the training program. Residents are provided with faculty advisors who meet with them and help provide content structure and practices for their presentations. The faculty member will help define and draft objectives for the presentation. Based on those objectives, questions will be obtained or written to evaluate those stated objectives. The intent of these presentations is to provide good quality in-house educational experiences for the residents and to provide a portion of the didactic program for the training program in Emergency Medicine. A written evaluation by a faculty member will be provided. This evaluation will give the resident some feedback as to their ability to present material in a lecture format. The objective here is two-fold. The first objective is to provide residency based, and thereby, more focused and attentive information resources for the didactic program and two, to provide the resident with some background experience and prepared materials for the educational aspects of their future careers. (See Section VI for suggestion on lecture preparation.)

4. Evaluation of Clinical Experience

a. Resident evaluation of service

The resident is expected to complete a monthly statement of the clinical and educational experience given on each rotation. The form should be self-explanatory. (See attached form A). Written comments of both clinical and personal issues are strongly encouraged. The specific form is not returned to the individual in charge of the service, but rather a tally of scores and a summary statement of written comments is sent yearly. This is to allow resident freedom in describing their experience. Documentation may be requested if particularly difficult circumstances were encountered.

b. Service evaluation of resident

Near the end of each month, the Department will mail our evaluation form (attached Form B) to the individual responsible for the educational content of the rotation. A prompt reply is expected. The form should be self-explanatory. The same form is sent for on-service (E.D.) evaluation, but it is accompanied by the "Emergency Department Rotation Evaluation Goals for Each Year in the Integrated Emergency Medicine Residency" (attached). This is a consensus document developed in 1986 to better define the breadth and level of performance expected on the E.D. rotation at each post-graduate year. It is recommended that a consensus opinion is assembled when this is appropriate and so designated on the form. It is strongly recommended that written comments be included to support the assessment. The residents do receive a copy of this report, but it should not preclude an honest, objective, appraisal of strengths and weaknesses. Neutral or "semi-good" comments are discouraged when a specific area has not been evaluated. A reference to "not applicable" is preferred.

Any questions/comments about the forms or specific comments about a resident performance that is preferentially not placed in writing should be communicated directly to the Program Director.

We have worked hard and will continue to develop our evaluation system. Emergency medicine specialists are continually tested by both patients and peer physicians. The resident must be placed in the somewhat stressful circumstance of aggressive evaluation to enable them to be secure in their data base, learn to "think on their feet," and to accept both positive and negative feedback in a mature and constructive manner.

This latter point is most important for evaluation must be linked to an anticipation of change if difficulties have been revealed. You are not assessed and graded for the ego gratification of the faculty, but rather to encourage your own growth and development. It is incumbent on each resident to respond openly and willingly to comments and criticisms made to them. A persistent defensive posture not only impedes education, but will impede progress through this training program.

5. Mid-year Program Evaluation

By January of each year, an extensive evaluation form is distributed to each resident. The form thoroughly reviews all of the components of the training program, allows a grading of rotations as well as individual clinical faculty, and encourages overview comments about the tone and direction of training. Signing the form is optional.

The faculty has these materials tallied, the comments assembled, and utilizes the information as a major focus of their late winter retreat. From this assessment, the Program and Associate Directors determine appropriate changes to be made in the training program and spend the next two to three months working to implement them. The new curriculum, both rotational and didactic, is then presented to the residents during the May full departmental retreat. This assessment and the faculty's response has been an integral part component of the evolution of this training program and full participation is strongly encouraged.

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