Abstract
Objectives: To compare 360-degree evaluation scores of postgraduate residents during 1st and 2nd cycles of evaluation to analyze the acquisition of core competencies.
Materials & Methods: A cross-sectional analytical study was done to compare the acquisition of core competencies as per ACGME by MS/MD residents in 3 public sector teaching hospitals of Rawalpindi. The enrolled residents undergone 1st and 2nd cycle of 360-degree evaluation from Jan-June 2018 and July 2018 -Jan 2019 respectively. The data was gathered from supervisors, faculty, nursing staff, patients and their attendants by structured proforma. Data was analyzed by SPSS version 25.0. Specialty-wise scores were statistically presented with 95% CI. Differences in scores of core competencies during both cycles were determined by independent sample t-test. P < 0.05 was considered significant.
Results: About 93 and 113 trainees were evaluated during 1st and 2nd cycle of evaluation respectively. Most (41.70%) of them were 1st year residents. 2nd cycle of evaluation revealed statistically significant improvement (P<0.00001) in all 6 core competencies. Feedback from the patients also illustrated significant difference in scores of both cycles (P = 0.01). Trainees of MS Surgery & Allied programs were determined as highly competent with 250.06 ± 38.57 score followed by those of MD Medicine & Allied (247.59 ± 42.15) and Gynecology & Obstetrics (246.71 ± 46.26) out of total score of 331. Residents of HFH and DHQ Hospital had statistically significant enhancement of competencies (P<0.0001) than those of BBH (P=0.003).
Conclusion: There was substantial enhancement of core competencies among postgraduate trainees.
References
Sharma S, Sharma V, Sharma M, Awasthi B, Chaudhary S. Formative assessments in postgraduate medical education – Perceptions of students and teachers. Int J Appl Basic Med Res 2015; 5 (Suppl 1): 66-70. https://doi.org/10.4103%2F2229-516X.162282.
Allofs L, Huiskes J, Heineman MJ, Buis C, Horsman M, Plank LVD, et al. User reception of a simple online multisource feedback tool for residents. Perspect Med Educ 2015; 4(2): 57-65. https://doi.org/10.1007/s40037-015-0173-0.
Educational theories you must know. Miller’s pyramid. St. Emlyn’s. https://www.stemlynsblog.org/better-learning/educational-theories-you-must-know-st-emlyns/educational-theories-you-must-know-millers-pyramid-st-emlyns/.
ECFMG. ACGME core competencies, 2020. Available at: https://www. ecfmg.org/echo/acgme-core-competencies.html.
GMC. Good medical practice, 2020. Available at: https://www.gmc-uk. org/ethical-guidance/ethical-guidance-for-doctors/good-medicalpractice.
Yavari N, Asghari F, Shahvari Z, Nedjat S, Larijani B. Obstacles of professional behavior among medical trainees: A qualitative study from Iran (2018). J Educ Health Promot 2019; 8: 193. https://doi.org/10.4103%2Fjehp.jehp_272_19.
Holmboe, Eric S., Jonathan Sherbino D. Michael Long, Susan R. Swing, and Jason R. Frank. 2010. The Role of Assessment in Competency-Based Medical Education. Medical Teacher 2010; 32(8): 676-682. https://doi.org/10.3109/0142159x.2010.500704.
Frank JR, Snell LS, Cate OT, Holmboe ES, Carraccio C, Swing SR, et al. “Competency-Based Medical Education: Theory to Practice.” Medical Teacher 2010; 32(8): 638-645. https://doi.org/10.3109/0142159x.2010.501190.
Tariq M, Govaerts M, Afzal A, Ali SA, Zehra T. Ratings of performance in multisource feedback: comparing performance theories of residents and nurses. BMC Med Educ 2020; 20: 355. https://doi.org/10.1186/s12909-020-02276-1.
Central Induction Policy. Last updated September 6, 2022. Available at: http://prp.phf.gop.pk/.
360-degree evaluation. Rawalpindi Medical University. https://rmur.edu.pk/?page_id=9020.
Frank JR, Snell LS, Cate OT, Holmboe ES, Carraccio C, Swing SR, et al. “Competency-Based Medical Education: Theory to Practice.” Medical Teacher 2010; 32(8): 638-645. https://html.scribdassets.com/5ylbutmosg8uqzpr/images/1-41320b54f0.png.
Eno C, Correa R, Stewart NH, Lim J, Westerman ME, Holmboe ES, et al. ACGME: Milestones guidebook for Residents and Fellows. 2020. https://www.acgme.org/globalassets/pdfs/milestones/milestonesguidebookforresidentsfellows.pdf.
Woolliscroft JO, TenHaken J, Smith J, Calhoun JG. Medical students’ clinical self-assessments: comparisons with external measures of performance and the students’ self-assessments of overall performance and effort. Acad Med 1993; 68(4): 285–294. https://psycnet.apa.org/doi/10.1097/00001888-199304000-00016.
Wood L, Hassell A, Whithouse A, Bullock A, Wall D. A literature review of multi-source feedback systems within and without health services, leading to 10 tips for their successful design. Medical Teacher 2006; 28(7): e185-e191. https://doi.org/10.1080/01421590600834286.
Epstein RM. Assessment in medical education. N Engl J Med 2007; 356(4): 387 96. https://doi.org/10.1056/nejmra054784.
Williams BW, Byrne PD, Welindt D, Williams MV. Miller’s pyramid and core competency assessment: A study in relationship construct validity. J Contin Educ Health Prof 2016; 36(4): 295-299. https://doi.org/10.1097/ceh.0000000000000117.
Witheridge A, Ferns G, Scott-Smith W. Revisiting miller’s pyramid in medical education: the gap between traditional assessment and diagnostic reasoning. Int J Med Educ 2019; 10: 191-192. https://doi.org/10.5116%2Fijme.5d9b.0c37.
Tariq M, Boulet J, Motiwala A, Sajjad N, Ali SK. A 360-degree evaluation of the communication and interpersonal skills of Medicine resident physicians in Pakistan. Education for Health 2014; 27(3): 269-276. https://doi.org/10.5116%2Fijme.5d9b.0c37.
Overeem K, Wollersheim H, Driessen E, Lombarts K, Van De Ven G, Grol R, et al. Doctors perceptions of why 360 degree feedback does (not) work: A qualitative study. Med Educ 2009; 43: 874 82. https://doi.org/10.1111/j.1365-2923.2009.03439.x.
Yazdankhah A, Norooz MT, Amoli HA, Aminian A, Khorgami Z, Khashayar P, et al. Using 360-degree multi-source feedback to evaluate professionalism in Surgery departments: An Iranian perspective. Med J Islam Repub Iran 2015; 29: 284. https://pubmed.ncbi.nlm.nih.gov/26913247.
Li H, Ding N, Zhang Y, Liu Y, Wen D. Assessing medical professionalism: A systematic review of instruments and their measuring properties. PLoS One 2017; 12(5): e0177321. https://doi.org/10.1371%2Fjournal.pone.0177321.
Whitehouse A, Hassell A, Bullock A, Wood L, Wall D. 360-degree assessment (Multi source feedback) of UK trainee doctors: Field testing of team assessment of behaviors (TAB). Medical Teacher 2007; 29(2-3): 171-176. https://doi.org/10.1080/01421590701302951.
Vilendrer S, Lestoquoy A, Artandi M, Barman L, Cannon K, Garvert DW, et al. A 360 degree mixed-methods evaluation of a specialized COVID-19 outpatient clinic and remote patient monitoring program. BMC Prim Care 2022; 23: 151. https://doi.org/10.1186/s12875-022-01734-7.
Fabricio TN, de Almeida GA, Fabricio AC, de Freitas MR, Vital AL, Gonclaves AK. Experience of the 360-degree evaluation and feedback system among obstetrics and gynecology residents: A pilot study. Int J Gynaecol Obstet 2021; 152(2): 264-266. https://doi.org/10.1002/ijgo.13368.
Fazal N, Abbasi SK, Masood S, Fatima T, Hussain S, Afzal RS. Assessment of the efficacy of reflective activities in Obstetrics and Gynecology residents for improving certain recognized abilities. PJMHS 2022; 16(7): 734-735. https://doi.org/10.53350/pjmhs22167734.
Spinnewijn L, Bolte AC, Braat DDM, Scheele F, Aarts JWM. Structurally collecting patient feedback on trainee skills: A pilot study in Obstetrics and Gynaecology. Patient Educ Couns 2022; 105(5); 1276-1282. https://doi.org/10.1016/j.pec.2021.08.026.
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
Copyright (c) 2023 Rizwana Shahid, Rabbia Khalid, Muhammad Umar, Sadia Khan