Graduating internal medicine residents’ self-assessment and performance of advanced cardiac life support skills

Abstract

Internal medicine residents in the US must be competent to perform procedures including Advanced Cardiac Life Support (ACLS) to become board-eligible. Our aim was to determine if residents near graduation could assess their skills in ACLS procedures accurately. Participants were 40 residents in a university-based training program. Self-assessments of confidence in managing six ACLS scenarios were measured on a 0 (very low) to 100 (very high) scale. These were compared to reliable observational ratings of residents’ performance on a high-fidelity simulator using published treatment protocols. Residents expressed strong self-confidence about managing the scenarios. Residents’ simulator performance varied widely (range from 45% to 94%). Self-confidence assessments correlated poorly with performance (median r = 0.075). Self-assessment of performance by graduating internal medicine residents was not accurate in this study. The use of self-assessment to document resident competence in procedures such as ACLS is not a proxy for objective evaluation.

Additional information

Notes on contributors

Diane B. Wayne

DIANE B. WAYNE, MD, is the director of the internal medicine residency program at Northwestern University Feinberg School of Medicine in Chicago, Illinois. She is interested in the use of simulation technology in residency training and the setting of rigorous competency standards for procedural skills.

John Butter

JOHN BUTTER, MD, is the associate director of the internal medicine residency program and director of the clinical education center at Northwestern University Feinberg School of Medicine.

Viva J. Siddall

VIVA J. SIDDALL, MS, is an assistant professor of clinical anesthesiology and education director of the Patient Safety Simulator Center at Northwestern Memorial Hospital in which this project was conducted.

Monica J. Fudala

MONICA J. FUDALA, BA, is the associate coordinator of the internal medicine residency program at Northwestern University Feinberg School of Medicine. Ms Fudala has substantial statistical expertise that was invaluable to the success of this project.

Leonard D. Wade

LEONARD D. WADE, MS, is an assistant professor of anesthesiology at Northwestern University Feinberg School of Medicine and serves as the technical director of the Patient Safety Simulator Center at Northwestern Memorial Hospital that was used in this report.

Joe Feinglass

JOE FEINGLASS, PhD, is a research associate professor in the division of general internal medicine at Northwestern University Feinberg School of Medicine and has extensive experience in patient safety and medical outcomes research.

William C. Mcgaghie

WILLIAM C. MCGAGHIE, PhD, is a professor of medical education and professor of preventive medicine at Northwestern University Feinberg School of Medicine. He is the senior investigator of this report and has been a medical education scholar for 30 years.