title: The McMaster Modular Assessment Program (McMAP): A Theoretically Grounded Work-Based Assessment System for an Emergency Medicine Residency Program.
abstract: OBJECTIVE
  To assess resident competence, generalist programs such as emergency medicine (EM), which cover a broad content and skills base, require a substantial number of work-based assessments (WBAs) that integrate qualitative and quantitative data.
  
  
  METHODS
  The McMaster Modular Assessment Program (McMAP), implemented in McMaster University's Royal College EM residency program in 2011-2012, is a programmatic assessment system that collects and aggregates data from 42 WBA instruments aligned with EM tasks and mapped to the CanMEDS competency framework. These instruments incorporate task-specific checklists, behaviorally anchored task-specific and global performance ratings, and written comments. They are completed by faculty following direct observation of residents during shifts. The rotation preceptor uses aggregated data to complete an end-of-rotation report for each resident in the form of a qualitative global assessment of performance.
  
  
  RESULTS
  The quality of end-of-rotation reports-as measured by comparing report quality one year prior to and one year after McMAP implementation using the Completed Clinical Evaluation Report Rating tool-has improved significantly (P < .001). This may be a result of basing McMAP's end-of-rotation reports on robust documentation of performance by multiple raters throughout a rotation rather than relying on a single faculty member's recall at rotation's end as in the previous system.
  
  
  CONCLUSIONS
  By aligning theory-based assessment instruments with authentic EM work-based tasks, McMAP has changed the residency program's culture to normalize daily feedback. Next steps include determining how to handle "big data" in assessment and delineating policies for promotion decisions.
authors.affiliation: T. Chan is assistant professor, Division of Emergency Medicine, Department of Medicine, McMaster University Michael G. DeGroote School of Medicine, Hamilton, Ontario, Canada, and student, Master of Health Professions Education Program, University of Illinois College of Medicine, Chicago, Illinois. J. Sherbino is associate professor, Division of Emergency Medicine, Department of Medicine, McMaster University Michael G. DeGroote School of Medicine, and adjunct scientist, Program for Educational Research and Development, McMaster University, Hamilton, Ontario, Canada.
authors.forename: Teresa
authors.initials: T
authors.lastname: Chan
authors.forename: Jonathan
authors.initials: J
authors.lastname: Sherbino
mesh_terms: D057189:Checklist; D002983:Clinical Competence / Q000592:standards* / Q000706:statistics & numerical data; D004635:Emergency Medicine / Q000193:education*; D006801:Humans; D007396:Internship and Residency / Q000592:standards* / Q000706:statistics & numerical data; D009864:Ontario; D016730:Program Development; D015397:Program Evaluation