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Are They Worth the Effort?

Arthur L. Schueneman, PhD; Jeffrey P. Carley; William H. Baker, MD

Arch Surg. 1994;129(10):1067-1073.

Abstract
Objective
The accuracy of rotation evaluation forms was assessed to determine the usefulness of clinical performance ratings in predicting competence in a general surgery residency.

Design
Longitudinal, 15-year, multifactorial, repeated-measures design.

Setting
University medical center residency training program.

Participants
General surgery and subspecialty residents (n=310) entering postgraduate training from 1976 to 1990 received 6459 rotation evaluations. Predictive efficiency of 4423 evaluations of a subsample of 199 residents admitted to the general surgery program during the study period was assessed using several outcome measures.

Main Outcome Measure
Attending surgeons categorized and ranked residents' competence at the completion of training.

Results
Rotation evaluations identified 77.8% of residents who involuntarily withdrew. Prediction of outcome category (problem, average, or superior residents), as well as final ranking (R²=.54), were demonstrated (P<.001). Evaluations of residents from the first year of training onward predicted outcome at the end of training (P<.01).

Conclusion
Rotation evaluations demonstrate predictive validity in documenting resident performance, particularly when the accuracy of individual raters is known.

(Arch Surg. 1994;129:1067-1073)

Author Affiliations
From the Department of Surgery, Loyola University Medical Center, Maywood, Ill.

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