Shadowing emergency medicine residents by medical education specialists to provide feedback on non-medical knowledge-based ACGME sub-competencies

Abstract

Objective

Non-medical knowledge-based sub-competencies (multitasking, professionalism, accountability, patient-centered communication, and team management) are challenging for a supervising emergency medicine (EM) physician to evaluate in real-time on shift while also managing a busy emergency department (ED). This study examines residents’ perceptions of having a medical education specialist shadow and evaluate their nonmedical knowledge skills.

Methods

Medical education specialists shadowed postgraduate year 1 and postgraduate year 2 EM residents during an ED shift once per academic year. In an attempt to increase meaningful feedback to the residents, these specialists evaluated resident performance in selected non-medical knowledge-based Accreditation Council of Graduate Medical Education (ACGME) sub-competencies and provided residents with direct, real-time feedback, followed by a written evaluation sent via email. Evaluations provided specific references to examples of behaviors observed during the shift and connected these back to ACGME competencies and milestones.

Results

Twelve residents participated in this shadow experience (six post graduate year 1 and six postgraduate year 2). Two residents emailed the medical education specialists ahead of the scheduled shadow shift requesting specific feedback. When queried, five residents voluntarily requested their feedback to be included in their formal biannual review. Residents received milestone scores and narrative feedback on the non-medical knowledge-based ACGME sub-competencies and indicated the shadow experience and subsequent feedback were valuable.

Conclusion

Medical education specialists who observe residents over the course of an entire shift and evaluate non-medical knowledge-based skills are perceived by EM residents to provide meaningful feedback and add valuable information for the biannual review process.

Keywords:

• evaluation
• observation
• milestones
• postgraduate
• residency
• behaviors
• performance

Supplementary materials

Figure S1 Milestone assessment

Notes: Copyright (c) 2015 The Accreditation Council for Graduate Medical Education and The American Board of Emergency Medicine. All rights reserved. The copyright owners grant third parties the right to use the Emergency Medicine Milestones on a non-exclusive basis for educational purposes.¹

Abbreviation: ACGME, Accreditation Council of Graduate Medical Education; SDOT, Standardized Direct Observation Tool.

Figure S2 Observation protocol for resident shadow/evaluation process and sample evaluation content.

Reference

• BeesonMChristopherTHeidtJJonesJPromesSMeyerLThe Emergency Medicine Milestone Project2015 Available from: http://www.acgme.org/Portals/0/PDFs/Milestones/EmergencyMedicineMilestones.pdfAccessed on July 12, 2017
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Disclosure

The authors report no conflicts of interest in this work.