Evaluation of resident communication skills and professionalism: a matter of perspective?
OBJECTIVE
Evaluation procedures that rely solely on attending physician ratings may not identify residents who display poor communication skills or unprofessional behavior. Inclusion of non-physician evaluators should capture a more complete account of resident competency. No published reports have examined the relationship between resident evaluations obtained from different sources in pediatric settings. The objective of this study was to determine whether parent and nurse ratings of specific resident behaviors significantly differ from those of attending physicians.


METHODS
Thirty-six pediatric residents were evaluated by parents, nurses, and attending physicians during their first year of training. For analysis, the percentage of responses in the highest response category was calculated for each resident on each item. Differences between attending physician ratings and those of parents and nurses were compared using the signed rank test.


RESULTS
Parent and attending physician ratings were similar on most items, but attending physicians indicated that they frequently were unable to observe the behaviors of interest. Nurses rated residents lower than did attending physicians on items that related to respecting staff (69% vs 97%), accepting suggestions (56% vs 82%), teamwork (63% vs 88%), being sensitive and empathetic (62% vs 85%), respecting confidentiality (73% vs 97%), demonstrating integrity (75% vs 92%), and demonstrating accountability (67% vs 83%). Nurse responses were higher than attending physicians on anticipating postdischarge needs (46% vs 25%) and effectively planning care (52% vs 33%).


CONCLUSIONS
Expanding resident evaluation procedures to include parents and nurses does enhance information that is gathered on resident communication skills and professionalism and may help to target specific behaviors for improvement. Additional research is needed to determine whether receiving feedback on parent and nurse evaluations will have a positive impact on resident competency.
Brinkman
William B
WB
Department of Pediatrics, Cincinnati Children's Hospital Medical Center, MLC 70353333 Burnet Ave, Cincinnati, OH 45229-3039, USA. bill.brinkman@cchmc.org
Geraghty
Sheela R
SR
Lanphear
Bruce P
BP
Khoury
Jane C
JC
Gonzalez del Rey
Javier A
JA
DeWitt
Thomas G
TG
Britto
Maria T
MT
D000328:Adult; D003142:Communication; D003625:Data Collection / Q000379:methods; D005260:Female; D006801:Humans; D007396:Internship and Residency; D007400:Interprofessional Relations; D008297:Male; D009726:Nurses; D010290:Parents; D010372:Pediatrics / Q000193:education*; D010820:Physicians; D011361:Professional Competence; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires