2020 Virtual International Conference on Residency Education.

Abstract

Introduction: Recent assessment innovations have included the development of resident-sensitive quality measures (RSQMs), which are characterized by: 1) their importance to care quality, and 2) likelihood they are performed by residents. This study explored how clinical competency committee (CCC) members interpret, use, and prioritize RSQM data added to their usual review processes.Methods: In this constructivist grounded theory study, 19 members of the Cincinnati Children’s pediatric residency CCC were purposively and theoretically sampled. Participants were provided a resident assessment portfolio comprised of performance ratings and narrative comments for five rotations, along with RSQM data for one of these rotations. They were asked to make a decision about the resident’s ability to care for patients presenting with common, acute problems (a general pediatric entrustable professional activity). Data collection consisted of: 1) observation and think aloud while participants reviewed performance data, and 2) semi-structured interviews to probe reviews.Results: Five dimensions for how participants view and use RSQMs were identified: 1) Ability to orient to RSQMs: confusing to self-explanatory, 2) Propensity to use RSQMs: reluctant to enthusiastic, 3) RSQM interpretation: requires contextualization to self-evident, 4) RSQMs for assessment decisions: not sticky to sticky, and 5) Expectations for residents: potentially unfair to fair to use RSQMs. The interactions among dimensions generated three RSQM data user profiles, with the first two being most common: eager incorporation, willing incorporation, and disinclined incorporation.Conclusion: Most participants used RSQMs to varying extents, demonstrating willingness to include them as resident assessment data for CCC review.