Evaluation of resident performance in an outpatient internal medicine clinic using standardized patients.
OBJECTIVE
To observe and evaluate the performance of primary care internal medicine residents within the outpatient clinic milieu.


METHODS
Longitudinal descriptive study.


METHODS
48 internal medicine resident encounters with two standardized patients at the University of Wisconsin General Internal Medicine Clinics.


METHODS
Residents were rated by the standardized patients with a medical skills checklist and an interpersonal skills checklist, and by the staffing physician with a clinical reasoning skills checklist. The investigators reviewed audiotapes of the standardized patient encounters for strategic management skills.


RESULTS
Resident performance on these scales was examined for improvement with years of training; when considered separately, no such effect was seen for either standardized patient case. When the cases were grouped together, however, there was significant improvement on the Clinical Reasoning Instrument. The grouped standardized patient data were compared with data from inpatient faculty evaluations of the residents. Faculty evaluations correlated with standardized patient evaluations of resident performance only on the medical checklist. Finally, comparison of the four assessment scales demonstrated a significant correlation between interpersonal skills, as assessed by the patient, and strategic management skills.


CONCLUSIONS
Resident outpatient performance, measured in a blinded setting, does not improve with year of training. Faculty inpatient assessments of residents correlate with medical "thoroughness" as measured by a medical skills checklist, and interpersonal skills as rated by standardized patients correlate with resident use of strategic medical management.
Department of Medicine, University of Wisconsin Hospital and Clinics, Madison 53792.
R P
RP
Day
M G
MG
Hewson
P
P
Kindy
J
J
Van Kirk
D000328:Adult; D002983:Clinical Competence; D004521:Educational Measurement / Q000379:methods*; D005260:Female; D006801:Humans; D007388:Internal Medicine / Q000193:education*; D007396:Internship and Residency; D008137:Longitudinal Studies; D008875:Middle Aged; D010044:Outpatient Clinics, Hospital; D010361:Patients