45. “INTERN CHECK-IN TOOL” TO IMPROVE EARLY IDENTIFICATION OF STRUGGLING INTERNS AND FACILITATE FEEDBACK

Abstract

Background Our current system for evaluation relies on faculty and peer evaluation of intern performance relating to general ACGME milestones. However, a program may have insufficient data to accurately identify a struggling intern until several months into the academic year. Objective To develop a brief, objective, resident-based evaluation tool to facilitate earlier identification of struggling interns in pediatric and internal medicine programs. Methods The intern check-in tool (ICT) consists of 18 items with a variety of observable key skills expected for interns (refer to attached form). It is scored on a 22-point scale of objective behaviors. Chief residents meet half way through each rotation and review the tool with senior residents supervising each intern. Results We implemented the use of the ICT at the beginning of the academic year in July 2018. Mid-year data are still being analyzed. In January 2019, after completion of the clinical competency committee (CCC) meetings, we will perform statistical analysis to measure correlations between the ICT scores and the overall intern performance as assessed by the CCC. We will also calculate the sensitivity and specificity for a range of ICT scores and measure correlations between the ICT scores and the demographic data, including medical school quartile and USMLE scores, for each intern. The ICT allowed us to identify a struggling intern early on who had multiple high scores. Following focused feedback and mentoring from senior residents, the intern's performance improved significantly prior to the CCC. The use of the tool has also identified interns struggling with wellness, who we have been able to integrate into a counseling program. Conclusions The pilot of the ICT may supplement more general milestone evaluations. Our data are preliminary but promising. This tool might be of benefit to other programs aiming to assess intern performance. It provides a forum for residents to learn the art of giving feedback and seek strategies to help their interns improve in real time.