Thresholds and interpretations: How clinical competency committees identify pediatric residents with performance concerns

Abstract

Background: Clinical competency committee (CCC) identification of residents with performance concerns is critical for early intervention.

Methods: Program directors and 94 CCC members at 14 pediatric residency programs responded to a written survey prompt asking them to describe how they identify residents with performance concerns. Data was analyzed using thematic analysis.

Results: Six themes emerged from analysis and were grouped into two domains. The first domain included four themes, each describing a path through which residents could meet or exceed a concern threshold:1) written comments from rotation assessments are foundational in identifying residents with performance concerns, 2) concerning performance extremes stand out, 3) isolated data points may accumulate to raise concern, and 4) developmental trajectory matters. The second domain focused on how CCC members and program directors interpret data to make decisions about residents with concerns and contained 2 themes: 1) using norm- and/or criterion-referenced interpretation, and 2) assessing the quality of the data that is reviewed.

Conclusions: Identifying residents with performance concerns is important for their education and the care they provide. This study delineates strategies used by CCC members across several programs for identifying these residents, which may be helpful for other CCCs to consider in their efforts.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.

Glossary

Clinical competency committee: A group of individuals responsible for reviewing and summarizing assessment data for a group of learners for the purposes of producing a summative assessment judgment.

Notes on contributors

Daniel J. Schumacher, MD, MEd, is an assistant professor of pediatric emergency medicine at Cincinnati Children’s Hospital Medical Center/University of Cincinnati, Cincinnati, OH, USA.

Catherine Michelson, MD, MMSc, is an assistant professor and pediatric program director, Department of Pediatrics, Boston University School of Medicine, Boston, MA, USA.

Sue Poynter, MD, Med, is an associate professor and pediatric program director, Department of Pediatrics, Cincinnati Children’s Hospital Medical Center/University of Cincinnati, Cincinnati, OH, USA.

Michelle M. Barnes, MD, is associate professor, associate head of education, and associate pediatric program director, Department of Pediatrics, University of Illinois at Chicago, Chicago, IL, USA.

Su-Ting T. Li, MD, MPH, is associate professor, vice chair of education and pediatric program director, Department of Pediatrics, University of California Davis, Sacramento, CA, USA.

Natalie Burman, DO, MA, is an assistant professor and associate program director, Department of Pediatrics, Naval Medical Center San Diego, San Diego, CA, USA.

Daniel J. Sklansky, MD, is an assistant professor and associate program director, Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.

Lynn Thoreson, DO, is an assistant professor and associate program director, Department of Pediatrics, The University of Texas at Austin Dell Medical School, Austin, TX, USA.

Sharon Calaman, MD, is an associate professor and pediatric program director, Department of Pediatrics, Drexel University College of Medicine, St. Christopher’s Hospital for Children, Philadelphia, PA, USA.

Beth King, MPP, is a research project manager, Association of Pediatric Program Directors (APPD) Longitudinal Educational Assessment Research Network (LEARN), McLean, VA, USA.

Alan Schwartz, PhD, is the Michael Reese Endowed Professor of Medical Education and Associate Head, University of Illinois at Chicago Department of Medical Education, Research Professor, University of Illinois at Chicago Department of Pediatrics, Chicago, Illinois, and Director, Association of Pediatric Program Directors Longitudinal Educational Assessment Research Network, McLean, VA, USA.