title: Utility of self-competency ratings during residency training in family medicine education-emerging countries: findings from Japan.
abstract: BACKGROUND
  Family medicine education-emerging countries face challenges in demonstrating a new program's ability to train residents in womb-to-tomb care and resident ability to provide such care competently. We illustrate the experience of a new Japanese family medicine program with resident self-competency assessments.
  
  
  METHODS
  In this longitudinal cross-sectional study, residents completed self-competency assessment surveys online during 2011-2015. Each year of training, residents self-ranked their competence using a 100-point visual analog scale for 142 conditions: acute (30 conditions), chronic (28 conditions) women's health (eight conditions), and geriatrics/home (12 conditions) care; procedures (38 types); health promotion (21 conditions).
  
  
  RESULTS
  Twenty residents (11 women, 9 men) participated. Scores improved annually by training year from baseline to graduation; the mean composite score advanced from 31 to 65%. All subcategories showed improvement. Scores for care involving acute conditions rose from 49 to 75% (26% increase); emergency procedures, 46-65% (19% increase); chronic care, 33-73% (40% increase); women's health, 16-59% (43% increase); procedural care, 26-56% (30% increase); geriatrics care-procedures, 8-65% (57% increase); health promotion, 21-63% (42% increase). Acute care, chronic care, and health promotion achieved the highest levels. Women's health care, screenings, and geriatrics experienced the greatest increase. Health promotion gains occurred most dramatically in the final residency year.
  
  
  CONCLUSIONS
  A resident self-competency assessment provides a simple and practical way to conduct an assessment of skills, to monitor skills over time, to use the data to inform residency program improvement, and to demonstrate the breadth of family medicine training to policymakers, and other stakeholders.
authors.affiliation: Department of Family Medicine, University of Michigan, 1018 Fuller Street, Ann Arbor, MI 48104-1213 USA.
authors.forename: Michael D
authors.identifier: 0000-0001-8521-5681
authors.initials: MD
authors.lastname: Fetters
authors.affiliation: Department of Family Medicine, University of Michigan, 1018 Fuller Street, Ann Arbor, MI 48104-1213 USA.
authors.forename: Satoko
authors.initials: S
authors.lastname: Motohara
authors.affiliation: School of Medicine, Loma Linda University, Loma Linda, CA USA.
authors.forename: Lauren
authors.initials: L
authors.lastname: Ivey
authors.affiliation: Department of Obstetrics/Gynecology and Family Medicine, Hamamatsu University, Hamamatsu, Japan ; Shizuoka Family Medicine Training Program, Shizuoka, Japan.
authors.forename: Keiichiro
authors.initials: K
authors.lastname: Narumoto
authors.affiliation: Department of Family Medicine, University of Michigan, 1018 Fuller Street, Ann Arbor, MI 48104-1213 USA ; Department of Family Medicine, Tokushukai Medical Corporation, Shizuoka, Japan.
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Sano
authors.affiliation: Shizuoka Family Medicine Training Program, Shizuoka, Japan.
authors.forename: Masahiko
authors.initials: M
authors.lastname: Terada
authors.affiliation: Shizuoka Family Medicine Training Program, Shizuoka, Japan.
authors.forename: Tsukasa
authors.initials: T
authors.lastname: Tsuda
authors.affiliation: Shizuoka Family Medicine Training Program, Shizuoka, Japan ; Department of Family and Community Medicine, Hamamatsu University, Hamamatsu, Japan.
authors.forename: Machiko
authors.initials: M
authors.lastname: Inoue
keywords: Competency; Developing countries; Evaluation; Family medicine; General medicine; Japan; Post-graduate education; Primary care; Residency training