A pilot survey study to define quality in residency education.
OBJECTIVE
To begin to define indicators of quality in internal medicine residency training.


METHODS
In 1995, through a modified Delphi process, the Association of Program Directors in Internal Medicine's Research Committee developed a questionnaire containing 44 items (34 process and ten outcome indicators). The survey was mailed to all 418 internal medicine program directors and a convenience sample of medical residents.


RESULTS
Responding at a rate of 78% (326), program directors rated several indicators as important. These included such faculty characteristics as stability, completeness, supervision, clinical skills, and teaching commitment; institutional support; amount of resident evaluation and feedback; encouragement of lifelong learning; and ability to meet its program goals. There was strong agreement between faculty and residents (r = 0.91). Items rated less important included graduates' selecting academic or generalist careers, residents' caring for elective cardiac catheterization patients, resident community service, training minorities and women, and faculty research.


CONCLUSIONS
These results demonstrate the diversity of opinion of what defines quality in residency education and the emphasis placed on process rather than outcome indicators. To be valid, future endeavors must include all those with a stake in graduate medical education, including accrediting bodies, future employers, and patients.
Klessig
J M
JM
UCLA San Fernando Valley Program, Sepulveda, California, USA.
Wolfsthal
S D
SD
Levine
M A
MA
Stickley
W
W
Bing-You
R G
RG
Lansdale
T F
TF
Battinelli
D L
DL
D001291:Attitude of Health Personnel; D002321:Career Choice; D002983:Clinical Competence; D003153:Community Health Services; D003697:Delphi Technique; D005180:Faculty, Medical / Q000592:standards; D005246:Feedback; D005260:Female; D006801:Humans; D007388:Internal Medicine / Q000193:education* / Q000592:standards; D007396:Internship and Residency / Q000592:standards*; D007398:Interpersonal Relations; D007858:Learning; D008913:Minority Groups / Q000193:education; D009937:Organizational Objectives; D017063:Outcome Assessment, Health Care; D010822:Physicians, Women; D010865:Pilot Projects; D017064:Process Assessment, Health Care; D019984:Quality Indicators, Health Care; D012106:Research; D013192:Staff Development; D011795:Surveys and Questionnaires; D013663:Teaching