title: Automated near-real-time clinical performance feedback for anesthesiology residents: one piece of the milestones puzzle.
abstract: BACKGROUND
  Anesthesiology residencies are developing trainee assessment tools to evaluate 25 milestones that map to the six core competencies. The effort will be facilitated by development of automated methods to capture, assess, and report trainee performance to program directors, the Accreditation Council for Graduate Medical Education and the trainees themselves.
  
  
  METHODS
  The authors leveraged a perioperative information management system to develop an automated, near-real-time performance capture and feedback tool that provides objective data on clinical performance and requires minimal administrative effort. Before development, the authors surveyed trainees about satisfaction with clinical performance feedback and about preferences for future feedback.
  
  
  RESULTS
  Resident performance on 24,154 completed cases has been incorporated into the authors' automated dashboard, and trainees now have access to their own performance data. Eighty percent (48 of 60) of the residents responded to the feedback survey. Overall, residents "agreed/strongly agreed" that they desire frequent updates on their clinical performance on defined quality metrics and that they desired to see how they compared with the residency as a whole. Before deployment of the new tool, they "disagreed" that they were receiving feedback in a timely manner. Survey results were used to guide the format of the feedback tool that has been implemented.
  
  
  CONCLUSIONS
  The authors demonstrate the implementation of a system that provides near-real-time feedback concerning resident performance on an extensible series of quality metrics, and which is responsive to requests arising from resident feedback about desired reporting mechanisms.
authors.affiliation: From the Department of Anesthesiology, Vanderbilt University School of Medicine, Nashville, Tennessee (M.D.M., W.R.F., and D.S.); and Departments of Anesthesiology, Surgery, and Biomedical Informatics Vanderbilt University School of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee (J.M.E. and W.S.S.).
authors.forename: Jesse M
authors.initials: JM
authors.lastname: Ehrenfeld
authors.forename: Matthew D
authors.initials: MD
authors.lastname: McEvoy
authors.forename: William R
authors.initials: WR
authors.lastname: Furman
authors.forename: Dylan
authors.initials: D
authors.lastname: Snyder
authors.forename: Warren S
authors.initials: WS
authors.lastname: Sandberg
mesh_terms: D000776:Anesthesiology / Q000193:education*; D001331:Automation; D002983:Clinical Competence / Q000592:standards*; D003199:Computer Systems; D003625:Data Collection; D003626:Data Display; D057286:Electronic Health Records; D005246:Feedback; D006801:Humans; D007396:Internship and Residency / Q000379:methods*; D007588:Job Satisfaction; D010820:Physicians; D058996:Quality Improvement