Identifying Gaps in the Performance of Pediatric Trainees Who Receive Marginal/Unsatisfactory Ratings.

摘要: Purpose To perform a derivation study to determine in which subcompetencies marginal/unsatisfactory pediatric residents had the greatest deficits compared with their satisfactorily performing peers and best discriminated between residents. Method Multi-institutional cohort of all 21 milestones (rated on four or five levels) reported Accreditation Council for Graduate Medical Education, global versus satisfactory performance American Board Pediatrics. Data were gathered 2013-2014. For each level training (postgraduate year [PGY] 1, 2, 3), mean differences milestone levels adjusted clustering by program C-statistics (area under receiver operating characteristic curve) calculated. A Bonferroni-corrected significance threshold .0007963 was used account multiple comparisons. Results Milestone overall evaluations 1,704 41 programs obtained. PGY1s, two almost one-point difference trainees outstanding discrimination (≥ 0.90): organize/prioritize (0.93; C-statistic: 0.91) transfer care (0.97; 0.90). The largest PGY2s trustworthiness (0.78). PGY3s ethical behavior (1.17), incorporating feedback (1.03), professionalization (0.96). PGY3s, no discrimination. Conclusions Marginal/unsatisfactory different subcompetency gaps at levels. While PGY1s may have deficits, senior deficiencies requiring individualized counseling targeted improvement plans.