Resident Evaluation Research Articles

Gender and the Receipt of the Association of Residents in Radiation Oncology (ARRO) Educator of the Year Award

Despite an increase in female physicians in recent years, a gender disparity remains in the field of radiation oncology. We hypothesized that there may be a gender disparity in the receipt of ARRO educator awards. Using a database provided by the American Society for Radiation Oncology (ASTRO), annual award recipients were identified from 2010-2022. Data on Academic Institution, Year of Award, and Repeat Awardee Status were obtained through the ASTRO database. Publicly available websites were accessed to obtain data regarding gender, years post residency graduation, percent female/male faculty, size of residency program, and program director designation. H- indices were obtained from Scopus and used as a marker of academic productivity. Basic summary statistics, stratified by gender, were calculated for award year, years since graduation, percent of male faculty, and program size. A one-sample Z-test for proportions was utilized to assess if the proportion of female ARRO award winners each year from 2010 to 2022 was significantly less than the population average, defined as the proportion of female radiation oncology faculty members in the nominating universities that year. Secondary analyses used univariable binary logistic regression to identify any global associations between gender, year since gradation, or program size. The lowest proportion of female awardees occurred in 2013 (8 [14.3%] females vs. 48 [85.7%] males) and the greatest proportion of female awardees occurred in 2022 (19 [30.6%] females vs. 43 [69.4%] males). As compared to the proportion of female faculty members in nominating programs for that respective year, there were significantly fewer female awardees in the years of 2010 (18% female awardees vs. 32% female faculty members, p = 0.02) and 2013 (14% female awardees vs. 31% female faculty members, p = 0.01). There was a statistically significant rise in female awardees over the study period (p<0.01). On logistic regression analysis, large program size (10+ residents) (odds ratio [OR]: 6.86, 95% confidence interval [CI]: 2.71-23.1, p<0.001) and medium program size (5-9 residents) (OR: 4.05, 95% CI: 1.60-13.7, p<0.001) were associated with a greater proportion of female awardees as compared to small program size (1-4 residents). There was no association between awardee gender and years since graduation. A gender disparity is present in the receipt of ARRO Educator Awards. At an institutional level, residency Chiefs, Program Directors, and Chairs should work to ensure that a diverse slate of faculty are considered annually for the ARRO Educator Award with self-assessment of awardees over time to ensure demographic representation and inclusion. Efforts should also be made to recognize biases in resident evaluations of faculty with continued education about inherent biases.

An overview of current evaluation methods of postgraduate dental specialty residents.

A lack of contemporary dental literature exists on evaluating dental residents in postgraduate education, with no standardized criteria or information on technology adoption. This study aims to understand current evaluation methods in dental residency programs and compare them to existing literature. A survey with 22 questions was sent to program directors of 749 ADA/CODA (American Dental Association/Commission on Dental Accreditation)-accredited postgraduate dental residencies. The questions focused on evaluation frequency, faculty involvement, submission methods, and electronic software usage. The survey response rate was 30.2% (226 responses). Results show that 98% of program directors are involved in evaluations, but require more support from auxiliary faculty. Evaluations are typically submitted twice or four times a year, with 12% of programs wanting increased frequency. Face-to-face delivery of feedback is considered crucial. While desktop computers are widely used for evaluation submission, 55% of programs utilize mobile devices, which correlates with higher program director satisfaction. The most popular evaluation software includes New Innovations, MEd Hub, and Qualtrics. Overall, 86.96% of program directors are satisfied with current evaluation practices. Areas needing improvement are non-program director faculty involvement, resident response/feedback, and software navigation. This study found that a majority of program directors of the postgraduate dental education system are using electronic technology for their resident evaluation systems and are satisfied with their current mechanism of evaluation.

Higher degree of impostor characteristics relates to lower self-perceived teaching ability and emotional intelligence.

Emotional intelligence (EI) has been previously associated with teaching ability and impostor phenomenon (IP) in medical education; however, studies have demonstrated mixed findings and have largely focused on trainees only. Therefore, we sought to explore the potential association between the degree of IP characteristics, EI and teaching ability in obstetrics and gynaecology (Ob/Gyn) faculty physicians. A cross-sectional, survey-based pilot study was completed at a single academic institution. Ob/Gyn attending (faculty) physicians were queried using surveys related to IP, EI and teaching ability. Resident (trainee) physicians also completed anonymous evaluations of faculty teaching ability. The degree of IP characteristics correlated negatively with self-perceived teaching ability, with no significant differences in resident assessment of faculty teaching. IP also correlated negatively with EI. Although there were no statistically significant differences in resident assessment of teaching ability based on EI, both EI and IP demonstrated inverse relationships to faculty assessment of teaching ability compared with resident assessment. IP appears to relate to lower perceived teaching ability in Ob/Gyn faculty that does not correspond to resident evaluation of teaching performance. The demonstrated negative correlation between the degree of impostor characteristics and EI suggests that EI could potentially play a protective role in the development of IP and burnout, as well as influence teaching. This relationship may have implications for faculty willingness to continue in academic medicine.

Evaluation and Remediation Strategies of Oral and Maxillofacial Surgery Residents: A National Cross-Sectional Survey

Evaluation and Remediation Strategies of Oral and Maxillofacial Surgery Residents: A National Cross-Sectional Survey

Enhancing the Value of Surgical Entrustable Professional Activities through Integrative Learning Analytics

To demonstrate the value of integrating surgical resident Entrustable Professional Activity (EPA) data into a learning analytics platform that provides meaningful feedback for formative and summative decision-making. Description of the Surgical Entrustable Professional Activities (SEPA) analytics dashboard, and examples of summary analytics and intuitive display features. Department of Surgery, University of Wisconsin Hospital and Clinics. Surgery residents, faculty, and residency program administrators. We outline the major functionalities of the SEPA dashboard and offer concrete examples of how these features are utilized by various stakeholders to support progressive entrustment decisions for surgical residents. Our intuitive analytics platform allows for seamless integration of SEPA microassessment data to support Clinical Competency Committee (CCC) decisions for resident evaluation and provides point of training feedback to faculty and trainees in support of progressive autonomy.

Differences in Resident Self-Evaluation and Clinical Competency Committee Evaluation Using ACGME Milestone Versions 1.0 and 2.0

Intentionally self-driven professional development of surgical resident physicians is a hallmark of surgical training and is expected to gain further traction as Entrustable Professional Activities (EPAs) become the new paradigm for surgical education. We aimed to analyze how surgical residents rate themselves as compared to the evaluation of the Clinical Competency Committee using ACGME Milestones Version 1 (M1.0) and Version 2 (M2.0). We asked 22 general surgical trainees for self-evaluation of Milestones (both M1.0 and M2.0) from 2017 semiannually to 2022. ACGME-required Milestone evaluations by the Clinical Competency Committee (CCC) were independently performed after the time window for resident self-evaluation. Neither trainees nor CCC were aware of the other party's evaluations. There were 1552 paired data available for evaluating individual competencies by both trainees and CCC. Paired Wilcoxon signed-rank tests were then performed among the corresponding pairs. MercyOne Des Moines Medical Center, Des Moines, IA; Teaching tertiary referral center. Twenty-two general surgical trainees at this hospital and 28 faculty surgeons participated in this study. The average self-evaluation of surgical residents was lower in the M1.0 cohort compared to the corresponding CCC evaluation (1.96 ± 0.72 vs. 2.11 ± 0.67; p < 0.001). M1.0 self-assessments and CCC-assessments were statistically similar for ICS (p = 0.548) and PROF (p = 0.554) competencies and differed for MK (p < 0.001), PBLI (p < 0.001), PC (p < 0.001), SBP (p = 0.008). On the contrary, the M2.0 cohort demonstrated higher average self-evaluation of surgical residents compared to the corresponding CCC evaluation (2.75 ± 0.87 vs. 2.12 ± 0.97; p < 0.001). Significant differences were observed for all 6 ACGME competencies using M2.0 self-assessments and CCC-assessments (all p < 0.001). Multivariate regression modeling (p < 0.001, R2 = 0.255) predicted the degree of discordance between self-assessment and CCC-assessed achievement of competencies with a significant effect of gender (baseline male: coef = -0.232, p < 0.001), PGY level (-0.083 per year, p < 0.001) and Milestone version (0.831, p < 0.001). A significant interaction exists for all gender/Milestone combinations except for the female trainees with M1.0. The difference between self-evaluated Milestone achievement and faculty-driven CCC evaluation of surgical resident physician performance is more evident in Milestones 2.0 than in Milestones 1.0. Residents self-evaluate higher compared to faculty using Milestones 2.0. This discrepancy is seen among both genders and is more pronounced among male residents overestimating core competencies with M2.0 self-evaluation than formal CCC assessment.

Assessment and evaluation of residents’ excess lifetime cancer risk of federal university of Kashere, Gombe State, Nigeria

A Study of indoor and outdoor radiation dose rate level measurements for male and female hostels at the Federal University of Kashere Hostels, Gombe State, Nigeria, has been carried out with the radiation alert smart 4 to ascertain the radiation level. The measured radiation dose rates were used to calculate the excess lifetime cancer risk and assess radiological health risks. The mean annual outdoor and indoor equivalent doses were 0.025 mSv/y. and 0.370 mSv/y. were recorded, with less than 1 mSv/y. maximum recommended limit for the general public. The mean annual outdoor and indoor effective doses were 0.017 mSv/y. and 0.086 mSv/y. respectively with a total of 0.103 mSv/yr. respectively. were computed. Mean outdoor and indoor ELCR values of 0.061X10-3and 0.302X10-3 respectively, with a mean total of 0.363X10-3 were also computed.

Impact of Faculty Incentivization on Resident Evaluations.

In the Program Requirements for Graduate Medical Education in Emergency Medicine, the Accreditation Council for Graduate Medical Education requires frequent and routine feedback. It is a common challenge for program leadership to obtain adequate and effective summative evaluations. This is a retrospective, case-crossover, interventional study conducted in an academic medical center. This study occurred over a two-year period, with an intervention between years one and two. Throughout year two of the study, faculty incentive compensation was linked to completion of end-of-shift evaluations. We compared pre- an post-implementation data using paired sample t-tests with the significance level P < .05 applied. After implementation of the incentive metric there was an increase in the number of total evaluations by 42% (P = .001). The mean number of evaluations submitted by each faculty per shift increased from 0.45 to 0.86 (SD 0.56, P < .001). Overall, 32 of the 38 faculty members (84.2%) had an increase in the number of evaluations submitted per shift during the intervention period with an average increase of 0.5 evaluations per shift (range 0.01-1.54). Incentivizing faculty to submit resident evaluations through use of bonus compensation increased the number of evaluations at our institution. This information may be applied by other programs to increase resident evaluations.

Design of a new competency-based entrustment scale for the evaluation of resident performance

PurposeRecent changes in the design and evaluation of residents to a more competency or mastery-based framework requires frequent observation, evaluation and documentation of residents by busy clinician teachers. Evaluating and determining competent performance is essential for formative evaluation and must be defensible and sound for summative purposes. We sought out experienced Faculty perspectives regarding: (1) important resident performance markers for demonstrating competent attainment of an EPA; (2) the standard of performance expected of graduating residents; (3) evidence for the validity of our purposed entrustment scale; and (4) necessary components required to provide feedback to residents in guiding the development of competent performance of an EPA.MethodsWe surveyed Canadian 172 neurosurgical Faculty who had publicly available email addresses and received 67 questionnaire responses, 52 of which were complete responses regarding resident performance markers and our proposed entrustment scale (ES) which consisted of five levels of graded achievement focused on resident performance.ResultsBeing able to “perform safely” was consistently rated as the most important element of competence that Faculty stated was the critical marker of competence that should be rated, and was found in the D and E Levels of our scale. Our scale does not include any commentary on “performing without supervision” which was rated as the least important marker of performance. For the graduating neurosurgical resident, 90.4% of Faculty indicated that residents should be capable of adapting performance or decisions in response to contextual complexities of the activity independently and safely (Level E) (67.3%) or being able to perform a procedure safely without complexities independently (level D) (21.3%). Eighty percent indicated that the descriptions of competence levels described in our ES (Level A through Level E) represent the appropriate progression of entrustment required demonstrating competent attainment of an EPA. Forty-four percent of Faculty had considerable concern about liability issues with certification of competence based on an ES that is based on descriptions of decreased or no supervision of residents. “Documenting a few weaknesses,” “providing contextual comments of the case,” “providing suggestions for future learning,” and “providing a global assessment for an EPA with one-rating” were rated as the most necessary components in providing effective feedback.ConclusionOur proposed entrustment global rating scale is easily understood by Faculty who indicate that its graded levels of competence reflect appropriate surgical resident progression in a feasible way. Faculty clearly indicated that the standard of a graduating resident should reflect the ability to perform safely beyond simply performing a case and be able to apply clinical judgments to be able to respond and alter behaviour in response to the clinical and contextual complexities of a case. Our scale focuses on evaluation of resident performance, rather than assessing the supervisor’s degree of involvement. This study has implications for the certification of competence of surgeons and physicians.

What influences general surgery residents' prospective entrustment and operative time in robotic inguinal hernia repairs.

Teaching residents robotic-assisted inguinal hernia repair (RIHR) is an increasingly common extension of contemporary surgical training. This study sought to investigate what variables would influence operative time (OT) and resident prospective entrustment in RIHR cases. We prospectively collected 68 resident RIHR operative performance evaluations with a validated instrument. Outpatient RIHR cases performed by 11 general surgery residents during 2020-2022 were included. The overall OT of matched cases was extracted from hospital billing; matched procedural step-specific OT was obtained from Intuitive Data Recorder (IDR). Statistical analysis was performed using Pearson correlation and one-way ANOVA. The evaluation instrument reliably assessed residents' RIHR performance (Cronbach's α = 0.93); residents' prospective entrustment strongly correlated with overall guidance provided by attending surgeon (r = 0.86, p < 0.0001) and operative plan and judgment (r = 0.85, p < 0.0001). The overall OT was significantly associated with resident's team management (r = - 0.35, p = 0.011). Procedural step-specific OT was significantly associated with residents' step-specific skill (r = - 0.32, p = 0.014). On average, RIHR cases with the highest level of prospective entrustment (Resident can teach junior) showed the shortest step-specific OT. Entrustment level 3 (Reactive guidance needed) was the turning point of all four RIHR procedural step-specific OT. Our findings suggest that in RIHR, attending guidance, resident operative plan and judgment, and resident technical skill contribute to resident prospective entrustment; resident team management, technical skill, and attending guidance influence operative time, which in turn impacts attendings' determination of resident prospective entrustment. Future studies with a larger sample size are needed to further validate the findings.

Evaluation of video teaching on resident competency for all-ceramic crown tooth preparation.

This study aimed to analyze the impact of live video instruction using digital evaluation of residents' performance in full ceramic crown preparation. Digital evaluation using CEREC computer-aided design/computer-assisted manufacturing (CAD/CAM) 5.1.3 software was conducted of preparation on a typodont for all-ceramic crowns of mandibular first molars (MFMs) with a radial shoulder finish line, carried out by 30 residents. Each participant prepared two MFMs: group A prepared the right side without live video instruction, and group B prepared the left side after instruction. All prepared teeth were scanned by Dentsply Sirona chairside CAD/CAM system with Omnicom to assess the inter-occlusal space, undercut, the finish line of the preparation, and surface texture. The data were analyzed using Pearson Chi-square, Wilcoxon signed-rank test, and paired t-test. P-values less than 0.05 were considered to be statistically significant in all tests. Based on the Pearson Chi-square test, there were significant differences between the two groups in terms of inter-occlusal space on the buccal and lingual surface of the prepared tooth, in the presence of rough surfaces before and after the preparation, and difference in the type of finish line. The Wilcoxon signed-rank test revealed a significant difference in convergence angle buccolingually and the remaining height of the prepared teeth before and after the video instruction. The use of educational live video instruction can be helpful to residents in learning the principles of tooth preparation.

Linguistic Differences by Gender in Letters of Recommendation for Maternal-Fetal Medicine Fellowship Applicants.

As in many realms of academia and medicine, in obstetrics and gynecology, women experience gender bias in residency evaluations and academic promotions. More specifically, women in Maternal-Fetal Medicine (MFM) are underrepresented within departmental leadership positions. As a means of identifying spaces where bias may exist, multiple investigators have previously reported on gender bias in letters of recommendation (LORs) for residency and subspecialty training programs. We aimed to determine if linguistic differences exist in LORs for self-identified male and female applicants to MFM fellowship at an academic institution. This was a retrospective single-site cohort study from 2019 to 2021. Data collected included applicant's age, self-reported race/ethnicity and gender, geographic region of residency, step 1 and 2 scores, scholarly and volunteer activities, and number of LORs. The Linguistic Inquiry and Word Count (LIWC) software, a validated text analysis program, was used to characterize LOR linguistic content. Multivariable analysis was used to compare letter characteristics to applicant demographics. A total of 212 applications were reviewed, including 808 LORs. Women comprised 76.9% of applicants, and men 23.1%. Most applicants identified as non-Hispanic White (52.8%). Men were more likely to be international medical graduates (20 vs. 6%, p ≤ 0.01), and women reported more volunteer activities (7.1 ± 5.1 vs. 5.5 ± 4.3, p = 0.04). There were no differences in step scores, number of research projects, or number of LORs. Multivariable analysis controlling for applicant race, step 1 score, and gender of letter writer revealed that letters written for males contained significantly more references to the word category cognitive processes (7.4 ± 0.2 vs. 7.1 ± 0.1, p = 0.046), specifically in reference to the subcategories of certainty and differentiation. We identified linguistic differences in LORs written for MFM applicants, suggesting potential bias in the style of writing for male and female physicians applying to this field. · Gender bias exists in the evaluation and promotion of women in medicine.. · We sought to determine whether it also exists in letters of recommendation for MFM fellowship.. · Previous studies have examined gender bias in letters of recommendation for other specialties.. · Linguistic bias was detected in letters of recommendation for MFM fellowship from 2019 through 2021.. · We found evidence of linguistic differences based on gender of applicant and letter writers..

Housing affordability in the capital cities of three Northwestern China provinces

PurposePrevious studies on housing affordability in China were concentrated in China’s coastal and central regions. The purpose of this paper is to investigate housing affordability of urban residents in Northwest China. Moreover, this paper attempts to understand the consistency and influencing factors of various indicators on the evaluation of housing affordability.Design/methodology/approachThis paper uses multiyear data on house sales, residents’ incomes and living expenses from 2011 to 2022. House price-to-income ratio, housing affordability index and residual income approach were calculated by using these data and used as the measure of housing affordability.FindingsThe results show that there are obvious differences in the housing affordability among the Xi’an, Lanzhou and Yinchuan during 2011–2022, and the housing affordability of residents in cities with small population and economic scale is better. The ability of most urban residents to afford suitable housing is still poor, and the ability to afford small-sized housing is better. Most families with below-middle income have poor housing affordability. It is also observed that although various indicators had similarities in the evaluation of residents’ housing affordability, the comprehensive evaluation results of multiple indicators were more reliable.Social implicationsThe research results provide a basis for the decision-making of the government’s urban housing policy and improvement of residents’ housing conditions.Originality/valueThe results have a clear understanding of the housing affordability of urban residents in Northwest China. The study found that the geographical location and topography of the city is also a factor affecting the housing affordability.

Barriers and Facilitators to Pediatric Resident Education in the Emergency Department: A Qualitative Study.

Objective Local resident evaluations of the pediatric emergency department (ED) declined over the last five years. Sparse literature exists on resident perspectives of educational experiences. This study explored the barriers and facilitators to resident education in the Pediatric ED. Methods This qualitative study utilized focus groups at a large pediatric training hospital. Trained facilitators performed semi-structured interviews prompting discussion of resident experiences in the pediatric ED. One pilot and six focus groups (38 pediatric residents) achieved data saturation. Sessions were audio recorded, de-identified and transcribed by a professional service. Three authors (CJ, JM, SS) analyzed the transcripts independently using line-by-line coding. Following code agreement, authors identified central themes drawing on grounded theory. Results Six categories emerged: (1) ED environment, (2) consistent goals, expectations, and resources, (3) ED workflow, (4) preceptor accessibility, (5) resident growth and development, (6) ED preconceived notions. Residents value a respectful work environment despite the chaotic nature of the ED. They need clear goals and expectations with a strong orientation. Autonomy, open communication and shared decision-making allowresidents to feel like team members. Residents gravitate toward welcoming, available preceptors that enthusiastically teach. More ED environment exposure increases comfort and efficiency and helps develop medical decision-making skills. Residents admit ED preconceptions and personality traits affect performance. Conclusion Residents self-identified barriers and facilitators to ED education. Educators must provide a safe and open learning environment, clear rotation expectations and goals, consistent positivity supporting shared decision making, and allow residents autonomy to build their practice styles.

Is Robotic Console Time a Surrogate for Resident Operative Autonomy?

Robotic-assisted surgery is an increasing part of general surgery training, but resident autonomy on the robotic platform can be hard to quantify. Robotic console time (RCT), the percentage of time the resident controls the console, may be an appropriate measure of resident operative autonomy. This study aims to characterize the correlation between objective resident RCT and subjectively scored operative autonomy. Using a validated resident performance evaluation instrument, we collected resident operative autonomy ratings from residents and attendings performing robotic cholecystectomy (RC) and robotic inguinal hernia repair (IH) at a university-based general surgery program between 9/2020-6/2021. We then extracted RCT data from the Intuitive surgical system. Descriptive statistics, t-tests and ANOVA were performed. A total of 31 robotic operations (13 RC, 18 IH) performed by 4 attending surgeons and 8 residents (4 junior, 4 senior) were matched and included. 83.9% of cases were scored by both attending and resident. The average RCT per case was 35.6%(95% CI 13.0%,58.3%) for junior residents (PGY 2-3) and 59.7%(CI 51.1%,68.3%) for senior residents (PGY 4-5). The mean autonomy evaluated by residents was 3.29(CI 2.85,3.73) out of a maximum score of 5, while the mean autonomy evaluated by attendings was 4.12(CI 3.68,4.55). RCT significantly correlated with subjective evaluations of resident autonomy (r=0.61, p=0.0003). RCT also moderately correlated with resident training level (r=0.5306, p<0.0001). Neither attending robotic experience nor operation type significantly correlated with RCT or autonomy evaluation scores. Our study suggests that resident console time is a valid surrogate for resident operative autonomy in robotic cholecystectomy and inguinal hernia repair. RCT may be a valuable measure in objective assessment of residents' operative autonomy and training efficiency. Future investigation into how RCT correlates with subjective and objective autonomy metrics such as verbal guidance or distinguishing critical operative steps is needed to validate the study findings further.

Operational efficiency evaluation of Urban and rural residents’ basic pension insurance system based on the triangular fuzzy neutrosophic GRA method

At present, the basic pension insurance system for urban and rural residents in China has played a positive role in guaranteeing the basic life of the elderly in urban and rural areas. At present, the basic pension insurance system for urban and rural residents is not perfect, and there is still a great lag in the formulation of cross-system and cross-regional policies. There are differences in treatment between groups, between regions and between urban and rural areas. The coverage is not comprehensive enough and there are still some people who are not included in the basic protection system, etc. People urgently need a social pension insurance system that can provide reliable and sustainable protection in their old age. The operational efficiency evaluation of urban and rural residents’ basic pension insurance systems is viewed as the multi-attribute decision-making (MADM). In this paper, the triangular fuzzy neutrosophic numbers grey relational analysis (TFNN-GRA) method is built based on the traditional grey relational analysis (GRA) and triangular fuzzy neutrosophic sets (TFNSs). Finally, a numerical example for operational efficiency evaluation of urban and rural residents’ basic pension insurance systems has been given and some comparisons are used to illustrate advantages of 2TLNN-GRA method.

A Role for Live-Animal Models in Undergraduate Surgical Education During the Cadaver Shortage.

A Role for Live-Animal Models in Undergraduate Surgical Education During the Cadaver Shortage.

Maintaining High Quality Dosimetry Education in Radiation Oncology Medical Residency Amid and Post-COVID-19 Pandemic: A Reimagined Training Rotation

Maintaining High Quality Dosimetry Education in Radiation Oncology Medical Residency Amid and Post-COVID-19 Pandemic: A Reimagined Training Rotation

Resident selection, assessment, and management: Proceedings of the 2022 ADEA Advanced Dental Education Summit.

The fifth biennial Advanced Dental Education Summit was organized by the ADEA Council on Advanced Education Programs. With a focus on "Resident selection, assessment, and management," the summit aimed to discuss best practices for selecting, assessing, and managing advanced education residents. Expert presentations covered the resident's journey from interview to graduation, emphasizing strategies for supporting resident wellness, success, and evaluation. The summit provided recommendations, including the incorporation of psychosocial assessments in the selection process, early recognition of behavioral issues, clearly defining clinical competencies, and creating a culture of wellness through supportive policies and structures.

Satisfaction among the Elderly Living in the Ancient Town of Xiangxi

This exploratory study combines the elderly-friendly post-use evaluation theory with the specific context of traditional residential buildings in typical Tujia ancient towns in the Western Hunan region, namely, Furong, Liexi, Xichehe, and Liye. A post-use low satisfaction evaluation model of traditional residential buildings in ancient towns was constructed, and the importance ranking of evaluation factors, along with the importance analysis of secondary indicators, was discussed using statistical methods. The subjective evaluations of elderly residents in different ancient towns toward the living environment and the importance ranking of factors for low satisfaction were examined. The findings of this study showed that we should focus on safety, convenience, health, privacy, belonging and cultural factors, and factors influencing sustainable livability for improving the quality of life of elderly residents in Tujia ancient towns in Western Hunan. Finally, the study proposes targeted improvement strategies to guide the construction of elderly-friendly environments in Tujia ancient towns and provide a reference for low satisfaction evaluations of ancient towns in similar economically underdeveloped areas.