Rules of engagement: residents' perceptions of the in-training evaluation process.
BACKGROUND
In-training evaluation reports (ITERs) often fall short of their goals of promoting resident learning and development. Efforts to address this problem through faculty development and assessment-instrument modification have been disappointing. The authors explored residents' experiences and perceptions of the ITER process to gain insight into why the process succeeds or fails.


METHODS
Using a grounded theory approach, semistructured interviews were conducted with 20 residents. Constant comparative analysis for emergent themes was conducted.


RESULTS
All residents identified aspects of "engagement" in the ITER process as the dominant influence on the success of ITERs. Both external (evaluator-driven, such as evaluator credibility) and internal (resident-driven, such as self-assessment) influences on engagement were elaborated. When engagement was lacking, residents viewed the ITER process as inauthentic.


CONCLUSIONS
Engagement is a critical factor to consider when seeking to improve ITER use. Our articulation of external and internal influences on engagement provides a starting point for targeted interventions.
Watling
Christopher J
CJ
London Health Sciences Centre, Victoria Hospital, 800 Commissioners Road E., Rm. C3-302, London, ON, Canada N6A 5W9. chris.watling@lhsc.on.ca
Kenyon
Cynthia F
CF
Zibrowski
Elaine M
EM
Schulz
Valerie
V
Goldszmidt
Mark A
MA
Singh
Indu
I
Maddocks
Heather L
HL
Lingard
Lorelei
L
D001291:Attitude of Health Personnel; D015331:Cohort Studies; D004521:Educational Measurement; D005260:Female; D006801:Humans; D007318:Inservice Training; D007396:Internship and Residency; D007400:Interprofessional Relations; D007407:Interviews as Topic; D007721:Knowledge of Results, Psychological; D008297:Male; D015397:Program Evaluation; D015203:Reproducibility of Results