Friday, December 18, 2015

Assessment in Competency-Based Medical Education: A Qualitative Study of Graduate Medical Education Faculty Perceptions

Sara Sukalich, MD, MEd
OhioHealth Riverside Methodist Hospital

Purpose: The literature is thus far largely silent regarding how graduate medical education faculty perceive trainee assessment in a competency based medical education. This study examined what the early faculty experience was with competency-based assessment of residents using the Accreditation Council for Graduate Medical Education (ACGME) milestones. The knowledge gained from this study could inform faculty development efforts, particularly in the areas of assessment and use of milestones.

Method: In 2015, the investigators conducted group interviews with 11 faculty members at an internal medicine program and two family medicine residency programs in Ohio. Inductive methods were used to identify major themes from the transcribed interviews.

Results: Four major themes emerged during analysis of the interviews. First, faculty members had a strong baseline understanding of competency-based medical education and use of the ACGME milestones. Second, it was noted that subjectivity remained with use of the milestones, which was seen as a risk to validity of assessment but also an important contributor to productive discussions in clinical competency committees. Third, consequences of the milestones were noted. Positive impacts included earlier identification of struggling learners and beneficial curriculum changes. The increased faculty time burden with milestones was seen as a key negative consequence. Finally, participants identified the need for faculty development, particularly for non-core faculty.

Conclusions:  The results of this small qualitative study contribute to the understanding of how faculty members experience the ACGME milestones. Although the milestones have positive consequences such as earlier identification of struggling learners, the increased burden on faculty time has been a negative outcome. Further research is needed to determine how to best capitalize on the perceived benefits of milestones and ameliorate negative consequences, particularly those that impact faculty well-being. Such information could greatly enhance faculty development initiatives.