Program Directors’ Perceptions of a Post-Match Competency Handover Between Medical School and Residency

Abstract

An educational handover at the completion of medical school that transmits competency information about individual learners has been proposed as a means for improving the sub-optimal communication between medical school and residency. The authors created an Accreditation Council for Graduate Medical Education (ACGME) milestones handover (MH) for graduating medical students entering surgery, pediatrics, and OBGYN residencies utilizing assessments primarily from residency preparatory courses. This pilot study investigated residency program directors’ (PDs) perspectives on the potential utility of the MH. The authors mapped medical school assessment data to the specialty-specific ACGME level one milestones for 39 graduating medical students. The MH reported whether the student had met the level one milestone competencies. After the residency match, the MH was sent to PDs with an electronic survey asking about their perceptions of the handover. The MHs reported level one competency determinations for most of the ACGME milestones (12 of 16 for surgery, 26 of 28 for OBGYN, and 18 of 21 milestones for pediatrics). Of the 38 surveyed PDs, 25 (66%) responded. PDs reported that the MH provided better level one competency information for new trainees compared to the Medical Student Performance Evaluation [Likert score 2.07 (SD 1.16) vs. 3.67 (SD 1.14), P < 0.05] however did not feel that it was superior in describing the attributes of a new intern [Likert score 3.32 (SD 0.95) vs. 3.68 (SD 0.95), P = 0.09]. This preliminary data suggests that the MH could be a potentially useful tool. Further work will need to expand these efforts to improve the generalizability and validity evidence of a competency-based educational handover between medical school and residency.