Assessment in a NutshellI love teaching but I hate filling in evaluation forms; does it really matter?
Regular assessment provides assurance that the student or resident is developing appropriate clinical skills. Assessment at below the expected standard is often the first indication of a learner in difficulty. Our everyday interactions with students or residents help shape our view of competency but more formal assessments are particularly important at 3 stages of each clinical rotation.
Beginning rotation
- What level is the learner functioning at? This will determine how much clinical independence the preceptor should allow and frames the way teaching should be directed.
Mid rotation
- What progress has the learner made? Are there any deficits to work on? Mid-rotation assessment plus feedback give the learner a chance to make important improvements before finishing the rotation. This is considered a formative assessment.
End rotation
- Has the learner reached the expected level of performance and met the rotation objectives? Do you see improvement from previous assessments? This assessment needs to be recorded and sent to the University as a summative assessment of performance in the clinical rotation.
A great way to assess your student or resident early in the rotation is by using RIME, described later in the website. For more detailed assessments use the university evaluation forms. These ask you to rate the learner’s performance across specific domains. This detailed breakdown is ideal for providing structured feedback to the learner. Also note down your overall impression of the learner. Global assessments of ability, generated after as few as 6 observations, correlate well with much more detailed assessments of competence.
Benchmarks for Family Medicine Residents
Many clinicians have difficulty assessing the progress of 1st year family medicine residents because the evaluation tools relate to competencies achieved by the end of the residency program. The University of Calgary has developed bench marks to guide preceptors. Bear in mind that residents can progress at widely different rates.
Benchmarking Family Medicine Residents
|
0 - 6 months |
Competent history and physical
Gaps in knowledge base
- Common family med problems
- Therapeutics
- Management strategies
May struggle to include psychosocial issues |
6 patients per half day
Consult preceptor for each patient
Initial investigations |
|
6 - 12 months |
More focused history and physical
Improved knowledge base
- Differential diagnosis highlights common and important conditions
- Appropriate investigations
Starts to include health promotion |
8 - 10 patients per half day
Consult preceptor for most patients |
|
End of 1st year |
Good rapport with patients
Identifies "red flag" symptoms / signs
Can priorize issues
Makes most therapeutic decisions
Tendency to overinvestigate
Wants increasing autonomy |
10 patients per half day
Frequently consults with preceptor |
|
18 months |
Can manage most cases alone
Aware of personal limitations
Good communication skills
- Can handle difficult interactions
- Modifies treatment plan to fit patient needs
|
10 -12 patients per half day
Consults preceptor for difficult cases
May challenge preceptors viewpoint
Identifies own learning needs |
|
End of 2nd year |
Manages full range of clinical duties |
12 - 14 patients per half day
Collegial relationship with preceptor
Rarely requires help |
Modified from University of Calgary document
Sample: Benchmarking Family Medicine Residents
For more about assessment visit:
Determining competence
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Assessment in a nutshell
- Assess at the beginning, middle and end of the rotation
- Global assessments are a good judge of competence
- Specific feedback necessary to improve performance
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