title: A New Instrument for Assessing Resident Competence in Surgical Clinic: The Ottawa Clinic Assessment Tool.
abstract: BACKGROUND
  The shift toward competency-based medical education has created a demand for feasible workplace-based assessment tools. Perhaps, more important than competence to assess an individual patient is the ability to successfully manage a surgical clinic. Trainee performance in clinic is a critical component of learning to manage a surgical practice, yet no assessment tool currently exists to assess daily performance in outpatient clinics for surgery residents. The development of a competency-based assessment tool, the Ottawa Clinic Assessment Tool (OCAT), is described here to address this gap.
  
  
  METHODS
  A consensus group of experts was gathered to generate dimensions of performance reflective of a competent "generalist" surgeon in clinic. A 6-month pilot study of the OCAT was conducted in orthopedics, general surgery, and obstetrics and gynecology with quantitative and qualitative evidence of validity collected. In all, 2 subsequent feedback sessions and a survey for staff and residents evaluated the OCAT for clarity and utility.
  
  
  RESULTS
  The OCAT is a 9-item tool, with a global assessment item and 2 short-answer questions. Among the 2 divisions, 44 staff surgeons completed 132 OCAT assessments of 79 residents. Psychometric data was collected as evidence of validity. Analysis of feedback indicated that the entrustability rating scale was useful for surgeons and residents and that the items could be correlated with individual competencies.
  
  
  CONCLUSIONS
  Multiple sources of validity evidence collected in this study demonstrate that the OCAT can measure resident clinic competency in a valid and feasible manner.
authors.affiliation: Department of Surgical Education, The University of Ottawa, Ottawa, Ontario, Canada. Electronic address: jrekman@toh.on.ca.
authors.forename: Janelle
authors.initials: J
authors.lastname: Rekman
authors.affiliation: Milestones Research and Evaluation at the Accreditation Council for Graduate Medical Education, Chicago, Illinois.
authors.forename: Stanley J
authors.initials: SJ
authors.lastname: Hamstra
authors.affiliation: Department of Medicine, The Ottawa Hospital Rehabilitation Center, The University of Ottawa, Ottawa, Ontario, Canada.
authors.forename: Nancy
authors.initials: N
authors.lastname: Dudek
authors.affiliation: Department of Innovation in Medical Education, University of Ottawa, Ottawa, Ontario, Canada.
authors.forename: Timothy
authors.initials: T
authors.lastname: Wood
authors.affiliation: Department of Surgical Education, The University of Ottawa, Ottawa, Ontario, Canada.
authors.forename: Christine
authors.initials: C
authors.lastname: Seabrook
authors.affiliation: Department of Surgical Education, The University of Ottawa, Ottawa, Ontario, Canada.
authors.forename: Wade
authors.initials: W
authors.lastname: Gofton
mesh_terms: D002983:Clinical Competence; D003162:Competency-Based Education; D004503:Education, Medical, Graduate; D004521:Educational Measurement / Q000379:methods*; D013502:General Surgery / Q000193:education*; D006801:Humans; D007396:Internship and Residency; D010865:Pilot Projects; D011594:Psychometrics; D011795:Surveys and Questionnaires
keywords: Interpersonal and Communication Skills; Medical Knowledge; OCAT; Patient Care; Professionalism; assessment; postgraduate education; surgical clinic; surgical competence; workplace-based assessment