Performance improvement? I thought we were perfect!

Residency Program Insider, June 17, 2008

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No program is perfect— there’s always room for improvement. That may be why the evaluation section of the ACGME’s Common Program Requirements state that the program must use information gleaned from evaluations to create an “action plan” for improvement.
Do not let this requirement fall through the cracks. Doing so will cause a last-minute flurry of activity prior to a residency review committee (RRC) site visit. Meeting this requirement takes a lot of work and a long trail of documentation— neither of which are easy to serve up in short order. To avoid scrambling at the last minute, consider exploring the following steps:            
Evaluate your evaluations. Every program should take a long, hard look at the following evaluations:

  • Faculty’s opinions of the program
  • In-service and board scores
  • Internal review report
  • Residents’ or fellows’ evaluations of the program and the rotations   

The benefits of assessing your evaluations are twofold. First, looking over the documents allows you to identify areas where your residents may not performing well—a hint that you may have to step up your teaching efforts in that area. Reviewing your evaluation tools also provides an opportunity to improve those tools. By perfecting them, you can gather better data about resident performance, which you can then use to enhance your curriculum. As you’ll see, this results in a program improvement cycle.
Use the annual curriculum review. A good time to dive into this important data is during the annual curriculum review. Use this opportunity to identify deficiencies in the educational dynamic of your program and address those shortcomings immediately. Any corrective actions should be a major adjustment to the program. Create an action plan that has measurable outcomes. Having measurable results will make it easy to show the ACGME how you improved.  
How do you go about developing that plan? First, bring the residents or fellows in on the discussion. Their insight is valuable to this process as they’re the ones most affected by changes in the academic program. Toss around ideas on what needs fixing and possible solutions. Develop a plan, chart its progress, and take stock later of how it worked, or didn’t. Document all of these meetings and actions by taking minutes.
As the site visit approaches, package it all up for the site visitor and show off your improvement efforts.
Sally T. Miller
Fellowship Administrator, Department of Medicine
University of Virginia


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