Evaluation of Residents

Formative and Summative Evaluation of Residents

Residents need frequent feedback throughout the course of each rotation, to reinforce well-performed duties and tasks, as well as to correct deficiencies. Feedback will encourage self-reflection and skill development as residents strive to achieve the Milestones. Feedback from faculty members in the context of routine clinical care should be frequent, and need not always be formally documented. More frequent feedback is strongly encouraged for residents who have deficiencies that may result in a poor final rotation evaluation.

Formative and summative evaluation have distinct definitions.

Formative evaluation is monitoring resident learning and providing ongoing feedback that can be used by residents to improve their performance. More specifically, formative evaluation:

  • helps residents identify their strengths and weaknesses and target areas that need work
  • Ensures that there are no surprises for the resident at the time of summative evaluation
  • helps program directors and faculty members recognize where residents are struggling and address problems immediately

Summative evaluation is evaluating a resident’s performance by comparing the residents against the goals and objectives of the rotation and program, respectively. Summative evaluation is utilized to make decisions about promotion to the next level of training, or program completion.

End-of-rotation and end-of-year evaluations can have both summative and formative components. Information from a summative evaluation can be used formatively when residents or faculty members use it to guide their efforts and activities in subsequent rotations and to successfully complete the residency program.

Each residency program must demonstrate that it has an effective plan for providing feedback and assessing resident performance throughout the program and for utilizing the results to improve resident performance. To achieve this:

  • Faculty members must directly observe, evaluate, and frequently provide feedback on resident performance during each rotation or experience.
  • Evaluation must be documented at the completion of the assignment.
    • For rotations of greater than three months in duration, evaluation must be documented at least every three months
    • Longitudinal experiences such as continuity clinic must be evaluated at least every three months and at completion.

The program must provide an objective performance evaluation based on the Competencies and the specialty-specific Milestones, and must:

  • use  multiple methods and instruments that produce an accurate assessment of residents’ competence in patient care, medical knowledge, practice-based learning and improvement, interpersonal and communication skills, professionalism, and systems-based practice;
  • use multiple evaluators (e.g., faculty members, peers, patients, self, and other professional staff members); and
  • provide that information to the Clinical Competency Committee for its synthesis of progressive resident performance and improvement toward graded responsibility and authority, and eventually unsupervised practice

The program director (or designee), with input from the Clinical Competency Committee, must:

  • meet with and review with each resident their documented semi-annual evaluation of performance, including progress along the specialty-specific Milestones;
  • assist residents in developing individualized learning plans to capitalize on their strengths and identify areas for growth; and
  • develop plans for residents failing to progress, following institutional policies and procedures.

At least annually, there must be a summative evaluation of each resident that includes their readiness to progress to the next year of the program, if applicable. The evaluations of a resident’s performance must be accessible for review by the resident.

Final Evaluation

The program director must provide a final evaluation for each resident upon completion of the program. Milestones, and, if applicable, Case Logs, must be used as tools to ensure residents are able to engage in autonomous practice upon completion of the program. The final evaluation must:

  • become part of the resident’s permanent record maintained by the program, and must be accessible for review by the resident ;
  • verify that the resident has demonstrated the knowledge, skills, and behaviors necessary to enter autonomous practice;
  • consider recommendations from the Clinical Competency Committee; and,
  • be shared with the resident upon completion of the program

The Office of Graduate Medical Education has an optional Final Evaluation template. To request an editable copy of the Final Evaluation, contact the Office of Graduate Medical Education at 217-545-8853 or email residency@siumed.edu.