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How Accurate is the ACGME Resident Survey? Comparison Between ACGME and In-House GME Survey

How Accurate is the ACGME Resident Survey? Comparison Between ACGME and In-House GME Survey. 1 Department of Surgery, The Methodist Hospital, Weill Cornell Medical College 2 The Methodist Hospital Education Institute. Bridget N. Fahy 1 , S. Rob Todd 1 , Judy L. Paukert 2 ,

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How Accurate is the ACGME Resident Survey? Comparison Between ACGME and In-House GME Survey

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  1. How Accurate is the ACGME Resident Survey?Comparison Between ACGME and In-House GME Survey 1 Departmentof Surgery, The MethodistHospital, Weill Cornell Medical College 2 The MethodistHospital Education Institute Bridget N. Fahy1, S. Rob Todd1, Judy L. Paukert2, Melanie L. Johnson1, Barbara L. Bass1 Association of Program Directors in Surgery 20 April 2010

  2. Disclosure • No financial conflict of interest

  3. Background • Purpose of annual Accreditation Council for Graduate Medical Education (ACGME) Resident/ Fellow Survey: • monitor graduate medical education • provide early warning of potential non-compliance • Not administered in conjunction with program site visit-- results are used at the time of the visit • Used to prompt early site visits for programs with significant areas of non-compliance

  4. Background • 15/32 questions allow only “yes/no” responses • Wording of some questions is confusing resident misunderstanding of the question* • Graduate Medical Education (GME) Department administers Annual Survey of Residents • similar content to ACGME survey • responses given using a 5-point Likert scale • opportunities for narrative responses for each question are solicited • Differences in the results obtained from the two surveys identified *Holt et al. Acad Med;85, 2010.

  5. How Accurate is the ACGME Resident Survey?

  6. Purpose of Study • Examine systematically the results of 15 questions on the two surveys that assessed similar information • identify areas of significant disparity

  7. Subjects • 26 general surgery residents • 4 categorical residents at each PGY level • 2 preliminary PGY2 residents • 4 preliminary PGY1 residents • Tertiary referral academic training center

  8. Survey Instruments • ACGME • www.acgme.org/acWebsite/resident_survey • 32-question survey administered annually • Response options: “yes/no” = 15, 3-point scale = 4, 5-point Likert scale = 9 • Residents assured of anonymity

  9. Survey Instruments • GME • 53-question survey administered annually • Administered to residents from all programs • Response options: majority given on 5-point Likert scale + option for narrative responses • Resident assured of anonymity

  10. Common Survey Items Faculty support 1. Do the faculty spend sufficient time teaching residents/fellow in your program? 2. Do the faculty spend sufficient time supervising residents/fellows in your program? 3. Do your faculty members regularly participate in organized clinical discussions, rounds, journal clubs, conferences? 4. Do you have the opportunity to confidentially evaluate your faculty, in writing, electronically, at least once a year? Rotation / program evaluation 5. Do you receive written or electronic feedback on your performance for each rotation? 6. Do you have the opportunity to confidentially evaluate your program, in writing, electronically, at least once a year? 7. Has your program provided you access to, either by hard copy or electronically, written goals and objectives for the program overall and for each rotation and major assignment? 8. Have residents/fellows had the opportunity to assess the program for the purposes of program improvement? Working / educational environment 9. Does your program and/or institution have a system through which you are able to raise and resolve issues without fear of intimidation or retaliation? 10. How often are you able to access, either in print or electronic format, the specialty specific and other reference materials that you need? 11. To what extent to trainees who are not part of your program (such as residents from other specialties, subspecialty fellows, Ph.D. students and nurse practitioners) interfere, in a negative way, with your education? 12. Do your rotations and other major assignments emphasize clinical education over any other concerns, such as fulfilling service obligations? 13. Does your program offer you the opportunity to participate in research or scholarly activities? Duty hours 14. Have you had sufficient education (from your program, your hospital(s), your institution, or your faculty) to recognize and counteract the signs of fatigue and sleep deprivation? 15. Have you met the ACGME duty hour requirements?

  11. Subject Demographics

  12. Faculty Support

  13. Rotation/Program Evaluation

  14. Work / Educational Environment

  15. Duty Hours Compliance

  16. Summary • Differences in responses found for 3 items: • Faculty time spent teaching • Interference of other trainees • Rotation emphasis of education over other concerns • Responses on ACGME survey were less favorable than on GME survey

  17. Conclusions • Two factors may contribute to inaccurate responses on ACGME survey: • Limited range of available responses • Confusing wording of questions • Inaccurate responses elicited on the ACGME survey may result in erroneously elevated rates of non-compliance • Further validation of the current ACGME survey is warranted

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