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Identifying Gaps in the Performance of Pediatric Trainees Who Receive Marginal/Unsatisfactory Ratings
Journal article   Open access   Peer reviewed

Identifying Gaps in the Performance of Pediatric Trainees Who Receive Marginal/Unsatisfactory Ratings

Su-Ting T. Li, Daniel J. Tancredi, Alan Schwartz, Ann Guillot, Ann Burke, R. Franklin Trimm, Susan Guralnick, John D. Mahan, Kimberly A. Gifford and Assoc Pediat Program Directors APP
Academic medicine, v 93(1)
01 Jan 2018
DOI: https://doi.org/10.1097/ACM.0000000000001775
PMID: 28640031
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
https://doi.org/10.1097/acm.0000000000001775View
Published, Version of Record (VoR)Maybe Open Access (Publisher Bronze),  Open
url
https://doi.org/10.1097/ACM.0000000000001775View
Published, Version of Record (VoR) Open

Abstract

Education & Educational Research Education, Scientific Disciplines Health Care Sciences & Services Life Sciences & Biomedicine Science & Technology Social Sciences
Purpose To perform a derivation study to determine in which subcompetencies marginal/unsatisfactory pediatric residents had the greatest deficits compared with their satisfactorily performing peers and which subcompetencies best discriminated between marginal/unsatisfactory and satisfactorily performing residents. Method Multi-institutional cohort study of all 21 milestones (rated on four or five levels) reported to the Accreditation Council for Graduate Medical Education, and global marginal/unsatisfactory versus satisfactory performance reported to the American Board of Pediatrics. Data were gathered in 2013-2014. For each level of training (postgraduate year [PGY] 1, 2, and 3), mean differences between milestone levels of residents with marginal/unsatisfactory and satisfactory performance adjusted for clustering by program and C-statistics (area under receiver operating characteristic curve) were calculated. A Bonferroni-corrected significance threshold of .0007963 was used to account for multiple comparisons. Results Milestone and overall performance evaluations for 1,704 pediatric residents in 41 programs were obtained. For PGY1s, two subcompetencies had almost a one-point difference in milestone levels between marginal/unsatisfactory and satisfactory trainees and outstanding discrimination (>= 0.90): organize/prioritize (0.93; C-statistic: 0.91) and transfer of care (0.97; C-statistic: 0.90). The largest difference between marginal/unsatisfactory and satisfactory PGY2s was trustworthiness (0.78). The largest differences between marginal/unsatisfactory and satisfactory PGY3s were ethical behavior (1.17), incorporating feedback (1.03), and professionalization (0.96). For PGY2s and PGY3s, no subcompetencies had outstanding discrimination. Conclusions Marginal/unsatisfactory pediatric residents had different subcompetency gaps at different training levels. While PGY1s may have global deficits, senior residents may have different performance deficiencies requiring individualized counseling and targeted performance improvement plans.

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8 citations in Web of Science
8 citations in Scopus

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#4 Quality Education

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Collaboration types
Domestic collaboration
Web of Science research areas
Education, Scientific Disciplines
Health Care Sciences & Services
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