title: What Shape is Your Resident in? Using a Radar Plot to Guide a Milestone Clinical Competency Discussion.
abstract: OBJECTIVE
  One of the challenges for program directors (PDs) is to sort and weight the tidal wave of assessments that training programs create in the modern Milestone era. We evaluated whether the use of a radar plot (RP) would be helpful in sorting data and providing a graphic representation of each resident's progress.
  
  
  METHODS
  Using at least 2 different types of assessments for each of the 16 surgical Milestones, the data were ranked and weighted by a predetermined method embedded in a computerized workbook (Excel). This process created a unique 16-spoked RP for each resident (Fig. below). The RP allowed the faculty to see areas of weakness (shown by concavity) and allowed an overall grade calculated as a ratio of the area of the smooth outer circle (faculty expectations, triangles) and the resident's unique radar shape (resident performance, squares). To help us validate our new tool, we looked at whether residents with recent remedial issues "looked" different from residents without remedial issues.
  
  
  RESULTS
  Of our 30 categorical residents, 8 had significant areas of concavities, suggesting possible areas of improvement. Of these 8 residents, 4 had been on a remediation program in the last 18 months. The average ratio of performance/expectations was 0.709. The 4 residents on recent remediation had a ratio of 0.616 when compared with 0.723 for the residents without remedial issues (p < 0.009).
  
  
  CONCLUSIONS
  Many exciting challenges await PDs, as we evolve to a competency-based evaluation system. The use of an evaluation summary tool using RPs may aid PDs in leading clinical competency discussions and in monitoring a resident's progress over time.
authors.affiliation: Alpert Medical School at Brown University, Rhode Island Hospital, Providence, Rhode Island. Electronic address: dharrington@usasurg.org.
authors.forename: David T
authors.initials: DT
authors.lastname: Harrington
authors.affiliation: Alpert Medical School at Brown University, Rhode Island Hospital, Providence, Rhode Island.
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Miner
authors.affiliation: Alpert Medical School at Brown University, Rhode Island Hospital, Providence, Rhode Island.
authors.forename: Thomas
authors.initials: T
authors.lastname: Ng
authors.affiliation: Alpert Medical School at Brown University, Rhode Island Hospital, Providence, Rhode Island.
authors.forename: Kevin P
authors.initials: KP
authors.lastname: Charpentier
authors.affiliation: Alpert Medical School at Brown University, Rhode Island Hospital, Providence, Rhode Island.
authors.forename: Pam
authors.initials: P
authors.lastname: Richardson
authors.affiliation: Alpert Medical School at Brown University, Rhode Island Hospital, Providence, Rhode Island.
authors.forename: William G
authors.initials: WG
authors.lastname: Cioffi
mesh_terms: D002983:Clinical Competence; D013502:General Surgery / Q000193:education*; D007396:Internship and Residency
keywords: Medical Knowledge; Practice-Based Learning and Improvement; Systems-Based Practice; assessments; competency; milestones; radar plot