Evaluation tools for general competencies

Competency                                                Tools Used

Medical Knowledge
  • Quarterly MCQ (Multiple Choice Questions)
  • American Board of Surgery In-training Examination
  • Formal Oral Exam (PGY 4 and PGY 5)
  • Monthly Performance Evaluation by Faculty and Chief Residents 
Interpersonal and
Communications Skills
  • Staff Member Evaluation
  • Attending Evaluation
  • Resident Evaluation
  • Attending Evaluation          
  • Resident Evaluation                         
  • Staff Member Evaluation 
Practice Based Learning
  • Attending Evaluation
  • Resident Evaluation
System Based Practice
  • Attending Evaluation          
  • Resident Evaluation                         
  • Staff Member Evaluation   

Evaluation tools for general competencies

General Competencies
The general competency assessment is based on:

1. Global Performance Ratings
2. Focused Observation and Evaluation
3. 360 Assessments
4. General Performance Evaluation
5. Structured Case Discussions
6. Formal Oral Exam
7. In-House Written Examinations
8. Review of Case or Procedure Log

Global Performance Ratings

The residents are evaluated monthly on their rotations by attendings and the chief resident they work with.
These evaluations cover the six general competencies and are always available for the residents to read. The
residents read and acknowledge that they have reviewed their evaluations by signing and making comments.
Residents with excellent performance get a letter of commendation from the Program Director. Residents
With poor performance meet with the Director for a discussion and the necessary remedial action.
These evaluations are compiled and reviewed for the semiannual meeting of individual residents with the
Program Director and the Advisory Committee at which time the resident's overall performance is evaluated
And discussed; and a written feedback after the meeting is given to each resident.
The semiannual meeting is used to get a feedback/input from the individual residents and is used to evaluate
The effectiveness of the training program.
Focused Observation and Evaluation
Selected attendings evaluate residents during their patient encounter in the operating room.
This evaluation is done concurrently (same day) and will be performed at least once in an academic year for each resident.

360 Assessments

The head nurse (- the Intensive Care Unit, the Operating Room, the Recovery Room and the wards), the social
worker and the physician assistants evaluate the residents once a year on patient care, professionalism,
interpersonal and communications skills among others. These evaluations are reviewed with the residents
and form part of the pool of evaluations discussed with the residents in their semiannual meeting with the
Advisory Committee.

General Performance Evaluation

The residents are evaluated by other residents once a year covering the six general competencies. An oral/
written feedback is given to the residents. These evaluations become part of the pool of evaluations, which are
reviewed by the Advisory Committee during their semiannual meeting with individual residents.

Structured Case Discussions

This is performed by the Program Director or a selected group of Attendings. The resident presents a case from history through examination, investigations, diagnosis and management plan examination, investigations, diagnosis and management plan.
The attending evaluates the resident's cognitive knowledge as well as the assessment of the patient and
analysis of the laboratory data to come to an acceptable diagnosis. The resident is evaluated in his decision
making ability-operative and non- operative management. If operative, the pre and post-operative care of the
patient are included.

If the resident's performance is poor, the attending informs the Director of Surgery for the necessary
remedial action. This becomes part of the resident's evaluations which are all reviewed when the resident
meets with the Advisory Committee semi annually.

Evaluation tools for general competencies

General Competencies

Formal Oral Exam

A group of attendings from the Advisory Committee are selected as examiners. The oral examination is for the
PGY 4 and 5 residents and is performed at least 3 times in a year.
The examiners meet with the residents in the Directors office. Three different examiners question each
resident. The examiners ask the residents questions about what to do in a clinical scenario by the examiner.
The resident is then critiqued on the case and advised accordingly on his/her performance.

In-House Written Examinations

The residents are given Multiple Choice Questions examination quarterly a year to cover a broad section of
General Surgery in both clinical and basic science.
This is used to evaluate the effectiveness of the resident curriculum and identify any changes that are
needed. It is also used as an evaluation tool for the residents.

Review of Case or Procedure Log

The department utilizes the computerized systems by the RRC for documenting operative and non-operative
cases. These procedure logs are reviewed by the associate program director at regular intervals (at least
once a month) to make sure:

  • Residents enter their cases
  • The volume and distribution of cases are commensurate with the PGY level of the resident
  • There is complexity of cases for the individual resident
  • There is equitable distribution of cases among residents
  • Residents are in line to meet the minimum numbers required in the defined categories and the Critical Care cases.

A print out of the defined categories for all residents is reviewed by associate program director regularly and
then with the residents. Both Director of Surgery and Program Director are informed of any deficiencies the residents involved are informed accordingly.
The Associate Program Director reports any deficiencies to the Advisory Committee at its the semi annual
meeting with the individual residents. The Committee evaluates the progress made by each resident.
The resident is informed accordingly.

Attending evaluations are performed monthly (except the Structured Case Discussions and Focused
Observation and Evaluation). Evaluation by other residents and staff members are performed at least once
a year. Copies of the evaluation forms are attached. All the evaluation tools are reviewed and a letter of
commendation is sent to residents who receive excellent evaluations. Residents with poor evaluations are
required to meet with the Director for a discussion of the evaluation. The evaluations are always available for
the residents to see.

These evaluations are all used by the Clinical Competence Committee to determine the Milestones of the

individual residents semi-annually.  The Milestones is part of the update reported to the ACGME

Residents meet individually with the Director of Surgery and the Advisory Committee to discuss their competency

evaluations and Milestones twice a year and an annual evaluation is written and kept as part of the resident’s record. A final

evaluation of each resident who completes the program is written and kept as a permanent record by the department.