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“You Want Me to Assess What?”

Faculty Perceptions of Assessing Residents From Outside Their Specialty

Burm, Sarah PhD; Sebok-Syer, Stefanie S. PhD; Lingard, Lorelei PhD; VanHooren, Tamara MD, FRCPC; Chahine, Saad PhD; Goldszmidt, Mark MD, PhD, FRCPC; Watling, Christopher J. MD, MMEd, PhD, FRCPC

doi: 10.1097/ACM.0000000000002771
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Problem: Competency-based medical education (CBME) demands that residents be directly observed performing clinical tasks; however, many faculty lack assessment expertise, and some programs lack resources and faculty numbers to fulfill CBME’s mandate. To maximize limited faculty resources, the authors explored training and deploying faculty to assess residents in specialties outside their own.

Approach: In spring 2017, 10 MD and 2 PhD assessors at a medium-sized medical school in Ontario, Canada, participated in a 4-hour training session, which focused on providing formative assessments of patient handover, a core competency of medical practice. Assessors were deployed to two clinical settings outside their own specialty—critical care and pediatrics—each completing 11 to 26 assessments of residents delivering patient handover. Assessors were subsequently interviewed regarding their experiences.

Outcomes: While assessors felt able to judge handover performance outside their specialty, their sense of comfort varied with their own prior experiences in the given settings. Lack of familiarity with the process of handover in a specific setting directly influenced assessors’ perceptions of their own credibility. Although assessors identified the potential benefits of cross-specialty assessment, they also cited challenges to sustaining this approach.

Next Steps: Findings indicate a possible “contextual threshold” for cross-specialty assessment: tasks with high context specificity might not be suitable for cross-specialty assessment. Introducing higher-fidelity simulation into the training protocol and ensuring faculty members are remunerated for their time are necessary to establish future opportunities for shared assessment resources across training programs.

S. Burm is an education specialist, Centre for Education Research and Innovation, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.

S.S. Sebok-Syer is an instructor, Department of Emergency Medicine, Stanford University School of Medicine, Palo Alto, California; ORCID: https://orcid.org/0000-0002-3572-5971.

L. Lingard is professor, Department of Medicine and Faculty of Education, and founding director and senior scientist, Centre for Education Research and Innovation, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.

T. VanHooren is assistant professor, Department of Paediatrics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.

S. Chahine is assistant professor, Department of Medicine and Faculty of Education, and scientist, Centre for Education Research and Innovation, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada; ORCID: https://orcid.org/0000-0003-0488-773X.

M. Goldszmidt is professor, Department of Medicine, and associate director and scientist, Centre for Education Research and Innovation, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada; ORCID: https://orcid.org/0000-0002-5861-5222.

C.J. Watling is professor, Department of Clinical Neurological Sciences and Department of Oncology, associate dean, Postgraduate Medical Education, and scientist, Centre for Education Research and Innovation, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada; ORCID: https://orcid.org/0000-0001-9686-795X.

Supplemental digital content for this article is available at http://links.lww.com/ACADMED/A679.

Acknowledgements: The authors want to acknowledge the faculty members who participated in this assessment innovation for their time and commitment.

Funding/Support: This innovation was funded by both the Academic Medical Organization of Southwestern Ontario (AMOSO) and a Schulich School of Medicine & Dentistry Dean’s Research Innovation Grant.

Other disclosures: None reported.

Ethical approval: Ethics approval was acquired from Western University’s Research Ethics Board (Project ID: 108391).

Previous presentations: The lead author (S.B.) has given a presentation reporting the implementation and early results of cross-specialty assessment at the Canadian Conference on Medical Education (CCME) on April 28, 2018 in Halifax, Nova Scotia, Canada.

Correspondence should be directed to Sarah Burm, Centre for Education Research and Innovation, Schulich School of Medicine and Dentistry, Western University, Suite H110, Health Sciences Addition, London, Ontario, Canada, N6A 5C1; telephone (519) 661-2111, ext. 22143; e-mail: sarah.burm@schulich.uwo.ca; Twitter: @sarah_burm.

© 2019 by the Association of American Medical Colleges