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Assessing competence in emergency medicine trainees: an overview of effective methodologies

Published online by Cambridge University Press:  21 May 2015

Jonathan Sherbino*
Affiliation:
Division of Emergency Medicine, McMaster University, Hamilton, Ont.
Glen Bandiera
Affiliation:
Division of Emergency Medicine, University of Toronto, Toronto, Ont.
Jason R. Frank
Affiliation:
Department of Emergency Medicine, University of Ottawa, Ottawa, Ont. and The Royal College of Physicians and Surgeons of Canada, Ottawa, Ont.
*
Department of Emergency Medicine, Hamilton Health Sciences 237 Barton St. E., Hamilton ON L8L 2X2; sherbino@mcmaster.ca

Abstract

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How do we define competence in emergency medicine (EM), and how do we know when a resident has achieved it? In recent years, the idea of physician competence has become widely recognized as being multidimensional. This has resulted in an emphasis on competency-based education and assessment. We describe an up-to-date model to assess competence in EM. An overview of appropriate EM assessment tools is provided, along with their significant strengths and limitations. Sample behaviours representative of core competencies commonly assessed in EM training are matched to appropriate assessment tools. This review may serve as an introductory resource for EM clinicians, teachers and educators involved in EM trainee assessment.

Type
Education • Enseignement
Copyright
Copyright © Canadian Association of Emergency Physicians 2008

References

1.Kane, MT. The assessment of professional competence. Eval Health Prof 1992;15:163–82.Google Scholar
2.Epstein, RM. Assessment in medical education. N Engl J Med 2007;356:387–96.CrossRefGoogle ScholarPubMed
3.Gray, JA. Continuing medical education: retooling and renaissance. Lancet 1986;1:1261–2.CrossRefGoogle ScholarPubMed
4.Leach, DC. Competence is a habit. JAMA 2002;287:243–4.Google Scholar
5.Neufeld, VR, Maudsley, R, Pickering, J, et al. Educating future physicians for Ontario. Acad Med 1998;73:1133–48.CrossRefGoogle ScholarPubMed
6.The CanMEDS Project. Canadian Medical Education Directions for Specialists. Royal College of Physicians and Surgeons, Canada. Available: http://rcpsc.medical.org (accessed 2007 Feb 8).Google Scholar
7.Four Principles of Family Medicine. Available: http://www.cfpc.ca (accessed 2007 Feb 8).Google Scholar
8.Murray, EL, Gruppen, P, Catton, R, et al. The accountability of clinical education; its definition and assessment. Med Educ 2000;23:871–9.Google Scholar
9.Irvine, D. Doctors in the UK: their new professionalism and its regulatory framework. Lancet 2001;358:1807–10.CrossRefGoogle ScholarPubMed
10.CPSA. Physician Achievement Review Program. Available: www.cpsa.ab.ca (accessed 2007 Feb 8).Google Scholar
11.Brown, N, Parry, E, Oyebode, F. Appraisal for consultant medical staff. Adv Psychiatr Treat 2003;9:152–8.Google Scholar
12.Alternative routes to certification for IMGs. The Royal College of Physicians and Surgeons of Canada. Available: http://rcpsc.medical.org/residency/certification/img_e.php (accessed 2007 Mar 4).Google Scholar
13.Airasian, P. Classroom assessment. 3rd ed. New York (NY): McGraw-Hill; 1997.Google Scholar
14.Epstein, RM, Hundert, E. Defining and assessing professional competence. JAMA 2002;287:226–34.Google Scholar
15.Leinster, S. Assessment in medical training. Lancet 2003;362:1770.Google Scholar
16.Abrahamson, S, Nyquist, J. Deciding how to evaluate competence. In: Lloyd, J, Langsely, D, Editors. How to evaluate residents. Chicago (Il): American Board of Medical Specialties; 1986.p. 4556.Google Scholar
17.Wass, V, Van der Vleuten, C, Shatzer, J, et al. Assessment of clinical competence. Lancet 2001;357:945–9.CrossRefGoogle ScholarPubMed
18.Bandiera, G, Sherbino, J, Frank, J. The CanMEDS Assessment Tools Handbook: An introductory guide to assessment methods for the CanMEDS Competencies. Ottawa (ON): Royal College of Physicians and Surgeons of Canada; 2006.Google Scholar
19.Wood, T, Cole, G. Developing multiple choice questions for the RCPSC certification examinations. Ottawa (ON): Office of Education, Royal College of Physicians and Surgeons of Canada; 2004.Google Scholar
20.Downing, S. Assessment of knowledge with written test forms, in international handbook of research in medical education. In: Norman, G, van der Vleuten, C, Newble, D, Editors. Dordrecht (Holland): Kluwer Academic Publishers; 2002. p. 647–72.Google Scholar
21.Coderre, SP, Harasym, P, Mandin, H, et al. The impact of two multiple-choice question formats on the problem-solving strategies used by novices and experts. BMC Med Educ 2004;4:23.CrossRefGoogle ScholarPubMed
22.Short Answer Questions. Guidelines for their development. Educational Research and Development Unit. Ottawa (ON): Royal College of Physicians and Surgeons of Canada; 2000.Google Scholar
23.Assessing clinical reasoning: the oral examination and alternative methods. In Mancall, E, Bashook, P, Editors. Evanston (IL): American Board of Medical Specialties; 1995.Google Scholar
24.Cunnington, JP, Hanna, E, Turnhbull, J, et al. Defensible assessment of the competency of the practicing physician. Acad Med 1997;72:912.Google Scholar
25.Turnbull, J, Van Barneveld, C. Assessment of clinical performance: in-training evaluation, in international handbook of research in medical education. In: Norman, G, van der Vleuten, C, Editors. Dordrecht (Holland): Kluwer Academic Publishers; 2002. p. 793810.Google Scholar
26.Gray, JD. Global rating scales in residency education. Acad Med 1996;71(Suppl):S55–63.CrossRefGoogle ScholarPubMed
27.Streiner, DL. Global Rating Scales. In: Neufeld, VR, Norman, GR, Editors. Assessing Clinical Competence. New York (NY): Springer Verlag; 1985. p. 119–41.Google Scholar
28.Bandiera, GW, Morrison, LJ, Regehr, G. Predictive validity of the Global Assessment Form used in a final-year undergraduate rotation in emergency medicine. Acad Emerg Med 2002;9:889–95.Google Scholar
29.Weaver, CS, Humbert, AJ, Besinger, BR, et al. A more explicit grading scale decreases grade inflation in a clinical clerkship. Acad Emerg Med 2007;14:283–6.CrossRefGoogle Scholar
30.Norcini, JJ, Blank, L, Duffy, F, et al. The mini-CEX: a method for assessing clinical skills. Ann Intern Med 2003;138:476–81.Google Scholar
31.Ziv, A, Wolpe, P, Small, S, et al. Simulation-based medical education: an ethical imperative. Acad Med 2003;78:783–8.Google Scholar
32.Lee, C. Objective structured clinical examinations (OSCEs) and objective structured performance-related examinations (OSPREs). In: Bandiera, G, Sherbino, J, Frank, J, Editors. The CanMEDS Assessment Tools Handbook: an introductory guide to assessment methods for the CanMEDS Competencies. Ottawa (ON): Royal College of Physicians and Surgeons of Canada; 2006. p. 23–5.Google Scholar
33.Hodges, BD. The objective structured clinical examination: three decades of development. J Vet Med Educ 2006;33:571–7.Google Scholar
34.van der Vleuten, C, Swanson, D. Assessment of clinical skills with standardized patients: state of the art. Teach Learn Med 1990;2:5876.Google Scholar
35.Rodgers, KG, Manifold, C. 360-degree feedback: possibilities for assessment of the ACGME core competencies for emergency medicine residents. Acad Emerg Med 2002;9:1300–4.Google ScholarPubMed
36.Matthews, D, Feinstein, A. A new instrument for patients’ ratings of physician performance in the hospital setting. J Gen Intern Med 1989;4:422.Google Scholar
37.Parboosingh, J. Role of self-assessment in identification of learning needs. J Contin Educ Health Prof 1998;18:213–9.Google Scholar
38.Eva, KW, Regehr, G. Self-assessment in the health professions: a reformulation and research agenda. Acad Med 2005; 80(Suppl):S46–54.Google Scholar
39.Regehr, G, Eva, K. Self-assessment, self-direction, and the self-regulating professional. Clin Orthop Relat Res 2006;449:34–8.CrossRefGoogle ScholarPubMed
40.O’Sullivan, P, Greene, C. Portfolios: possibilities for addressing emergency medicine resident competencies. Acad Emerg Med 2002;9:1305–9.Google Scholar
41.Hunskaar, S, Heim, SH. Asessment of student’s experiences in technical procedures in a medical clerkship. Med Educ 1983;17:300–9.Google Scholar
42.Lim, TO, Soraya, A, Ding, L, et al. Assessing doctors’ competence: application of CUSUM technique in monitoring doctors’ performance. Int J Qual Health Care 2002;14:251–8.Google Scholar
43.Tugwell, P, Dok, C. Medical record review. In: Berk, R, editor. Performance assessment: methods and applications. Baltimore (MD): Johns Hopkins University; 1986. p. 5170.Google Scholar