Utility of self-competency ratings during residency training in family medicine education-emerging countries: findings from Japan

Michael D Fetters,Keiichiro Narumoto,Machiko Inoue,Kiyoshi Sano,Lauren Ivey,Satoko Motohara,Tsukasa Tsuda,Masahiko Terada

doi:10.1186/s12930-016-0031-1

Abstract

BackgroundFamily medicine education-emerging countries face challenges in demonstrating a new program’s ability to train residents in womb-to-tomb care and resident ability to provide such care competently. We illustrate the experience of a new Japanese family medicine program with resident self-competency assessments.MethodsIn this longitudinal cross-sectional study, residents completed self-competency assessment surveys online during 2011–2015. Each year of training, residents self-ranked their competence using a 100-point visual analog scale for 142 conditions: acute (30 conditions), chronic (28 conditions) women’s health (eight conditions), and geriatrics/home (12 conditions) care; procedures (38 types); health promotion (21 conditions).ResultsTwenty residents (11 women, 9 men) participated. Scores improved annually by training year from baseline to graduation; the mean composite score advanced from 31 to 65%. All subcategories showed improvement. Scores for care involving acute conditions rose from 49 to 75% (26% increase); emergency procedures, 46–65% (19% increase); chronic care, 33–73% (40% increase); women’s health, 16–59% (43% increase); procedural care, 26–56% (30% increase); geriatrics care-procedures, 8–65% (57% increase); health promotion, 21–63% (42% increase). Acute care, chronic care, and health promotion achieved the highest levels. Women’s health care, screenings, and geriatrics experienced the greatest increase. Health promotion gains occurred most dramatically in the final residency year.ConclusionsA resident self-competency assessment provides a simple and practical way to conduct an assessment of skills, to monitor skills over time, to use the data to inform residency program improvement, and to demonstrate the breadth of family medicine training to policymakers, and other stakeholders.

Highlights

Medicine education-emerging countries face challenges in demonstrating a new program’s ability to train residents in womb-to-tomb care and resident ability to provide such care competently
To avoid confusion with their postgraduate year (PGY), residents were categorized by their family medicine (FM) training year (FMY), e.g., FMY1 means first year of FM training
As not all residents took the survey all years, the number of surveys taken differed by FMY; trainees completed the survey at baseline, trainees responded after completing FMY1, 11 after FMY2, and 11 after FMY3

Summary

Introduction

Medicine education-emerging countries face challenges in demonstrating a new program’s ability to train residents in womb-to-tomb care and resident ability to provide such care competently. We illustrate the experience of a new Japanese family medicine program with resident self-competency assessments. In many countries, FM is unrecognized or just emerging as a specialty [5,6,7,8,9] In such places FM programs often lack resources for teaching and evaluating residents using the types of intensive oneon-one teaching procedures and complex competency or milestone evaluations that characterize FM education in more experienced countries. FMEE academic programs face many barriers in launching a new discipline that impacts training at the student, resident, and faculty levels

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Results

Discussion

Conclusion