Program Evaluation
The program is evaluated by both informal and formal means. First, the residents complete a multi-page questionnaire about the program, with ample opportunity for comments, once each year. The results of these questionnaires are reviewed at the Program Administration Meeting, and the data are discussed during Chief Resident, Resident, and Education Committee meetings.
Second, overnight retreats are held each year for each post-graduate class, during which the residents discuss the strengths and weaknesses of the program both in small groups and in plenary sessions. The minutes of these meetings are disseminated to the principals of the program. The Program Director is held accountable for addressing all issues raised.
Third, there is a residents meeting monthly to discuss problems and/or possible improvements in the program.
Fourth, a Program Administration meeting is held each week. This meeting, attended by present and incoming Chief Residents, the Program Director, and the Associate Program Directors and the Chiefs of Medicine, is convened to discuss any issues that have occurred during the week in order to deal with them in a timely manner.
Lastly, an Education Committee, chaired by the Program Director with membership from faculty members, and Chief Residents, meets regularly to review the data gathered in the above-mentioned fora. The committee is charged with reviewing program goals and objectives, institutional resources dedicated to education, patient volume and variety, quality of teaching and housestaff supervision and the program's effectiveness in achieving its goals.
Housestaff Evaluation Committee
The Housestaff Evaluation Committee meets monthly to review the progress of all Medicine and combined-Medicine residents. The Committee is chaired by the Associate Program Director for Education, nine other attending physicians, the current Chief Residents, and the Program Director as a non-voting member, for a total of thirteen. The role of the Committee is to ensure that all residents are evaluated on a regular basis, that problems are identified in a timely manner and that the appropriate feedback and follow-up occur.
During each meeting, all issues of the last meeting are reviewed, and current problems are discussed. Events of the last month, including any grade of four (out of nine) or below received by a resident on any component of a monthly evaluation, become part of the meeting's agenda. In addition, all residents who are listed in the "potential file" as having an ongoing problem are discussed for current input. When a resident is seen as having a new or an ongoing difficulty, a member of the Committee is assigned to meet with the resident and report back to the Committee orally and in writing at the next meeting.
Each class of residents is reviewed twice yearly. The evaluations for each trainee are examined and discussed, and a current grade is assigned, often with comments. Beginning with the 2004-2005 academic year, these grades are determined by a weighted point system that takes into account monthly evaluations, completion of assigned duties and disciplinary actions. These grades are reported to the residents when the Committee Chairperson sees them for their twice-yearly individual feedback meeting. The ratings are also incorporated into the yearly evaluations completed for the American Board of Internal Medicine.
Medical Housestaff Evaluation
All residents are evaluated for monthly rotations by their attending physicians. The written evaluation form, modeled on the prototype created by the American Board of Internal Medicine (see attached), contains a box that must be checked to indicate that verbal feedback took place as well. If it is not checked, the evaluation is returned to the attending physician for the verbal feedback to be given. All residents are evaluated quarterly on their experience in the ambulatory continuity setting.
A copy of the evaluation form is mailed to the resident as soon as it is received. Evaluations that suggest marginal or unsatisfactory performance are forwarded to the Residency Program Director and to the Chairperson of the Evaluation Committee for review. A folder holding all evaluations is kept in the resident's permanent file, and this file is available for review by the resident.
In addition to being evaluated by the supervising attending physician, each resident is also evaluated by the third and fourth year students who are assigned to his or her service. The students evaluate residents on how well they teach, assigning grades and writing comments. These assessments are mailed periodically to residents and are also made part of their permanent evaluation file. Lastly, all residents on a specific medical team those not in the same year of trainng each month.
The Houesestaff Evaluation Committee reviews each resident's file twice yearly and this review forms the basis for a formal feedback session with the Chairperson of the Evaluation Committee. The resident's strengths and weaknesses are reviewed and if indicated, a plan is designed for improvement. A report of this meeting is submitted to the resident's permanent evaluation file.
During the first 6 months of the PGY-1 year, each resident is individually observed on four separate occasions performing the specific tasks of patient management as part of a Mini - Clinical Evaluation Exercise. The skills assessed include medical interviewing, physical examination, humanistic qualities and professionalism, clinical judgement, counseling skills, organization and efficiency, and overall clinical competence. The results of this exercise are included in the resident's permanent file and are utilized by the Evaluation Committee for overall assessment of clinical competence. Residents cannot be promoted to the PGY-2 year without successfully completing this exercise.
Faculty Teaching Evaluation
All faculty members are evaluated every month they attend on a resident-teaching rotation. Each resident fills out an evaluation form, which can be performed anonymously if the resident wishes.
These forms are collected every month and are kept until the summer when an individual summary report of the year's evaluations is typed, made part of the faculty member's permanent file, and mailed to the individual attending physician and his or her Section Chief. The summary is also made available to the Promotions Committee when that faculty member is being considered for promotion.
Faculty are encouraged to solicit informal feedback on their teaching effectiveness from the residents and students on their service. This information plus the yearly summary derived from the monthly evaluation forms should provide faculty with information on how to improve their teaching skills. In addition, a videotape program on teaching skills is available for those faculty who wish assistance improving their teaching.
Faculty members are also evaluated informally during weekly Chief Resident meetings, monthly Housestaff Evaluation and Residents' meetings, periodic Education Committee meetings, and yearly Housestaff Retreats. Important positive feedback occurs yearly, when the Attending Physician of the Year is voted on by all of the resident classes, and that person is honored at the end-of year graduation dinner.
Lastly, annually, residents are asked to complete an evaluation of each faculty members' ability to teach on a scale of 1 to 10. All faculty at or above the 90 th percentile receive certificates of excellence. Those below the 10 th percentile are reassigned to non-teaching duties.
Revised 4/28/04, 6/28/004
