AEM Education and Training 39: Implementation of a Pilot Novel Objective Peer Comparison Evaluation System in an Emergency Medicine Residency Program
Welcome to the thirty-ninth episode of the AEM Education and Training Podcast, a FOAMed podcast collaboration between the Academic Emergency Medicine Education and Training Journal and Brown Emergency Medicine.
Find this podcast series on iTunes here.
DISCUSSING:
Kraftin E. Schreyer MD, MBA, Megan E. Healy MD, Zachary Repanshek MD, Wayne A. Satz MD, Jacob W. Ufberg MD
LISTEN NOW: INTERVIEW WITH AUTHOR
Dr. Kraftin E. Schreyer, MD MBA is an attending physician and Associate Professor of Emergency Medicine at the Lewis Katz School of Medicine at Temple University.
Abstract
Objectives
Emergency medicine (EM) residents are currently evaluated via The Milestones, which have been shown to be imperfect and subjective. There is also a need for residents to achieve competency in patient safety and quality improvement processes, which can be accomplished through provision of peer comparison metrics. This pilot study aimed to evaluate the implementation of an objective peer comparison system for metrics that quantified aspects of quality and safety, efficiency and throughput, and utilization.
Methods
This pilot study took place at an academic, tertiary care center with a 3-year residency and 14 residents per postgraduate year (PGY) class. Metrics were compared within each PGY class using Wilcoxon signed-rank and rank-order analyses.
Results
Significant changes were seen in the majority of the metrics for all PGY classes. PGY3s accounted for the significant change in EKG and X-ray reads, while PGY1s and PGY2s accounted for the significant change in disposition to final note share. Physician evaluation to disposition decision was the only metric that did not reach significance in any class.
Conclusions
These preliminary data suggest that providing objective metrics is possible. Peer comparison metrics could provide an effective objective addition to the milestone evaluation system currently in use.