Resident Physician Interactions and Engagement With Written Assessments of Performance.

BACKGROUND AND OBJECTIVES:  Despite the requirements of the Accreditation Council for Graduate Medical Education (ACGME) to provide feedback, assessments are often not meeting the needs of resident learners. The objective of this study was to explore residents' approach to reviewing, interpreting, and incorporating the feedback provided in written faculty assessments.

METHODS:  We conducted semistructured interviews with 14 family medicine residents. We used line-by-line iterative coding of the transcripts through the constant comparative method to identify themes and reach a consensus.

RESULTS: The study revealed the following themes: (1) residents value the narrative portion of assessments over numerical ratings, (2) performance reflection and reaction are part of the feedback process, (3) residents had difficulty incorporating formal assessments as many did not provide actionable feedback.

CONCLUSIONS:  Residents reported that narrative feedback gives more insight to performance and leads to actionable changes in behaviors. Programs should consider education for both faculty and residents on the usefulness, importance, and purpose of the ACGME Milestones in order to accurately determine resident competency and provide a summative assessment. Until the purpose of the ACGME Milestones is realized and utilized, it should be noted that the comment portion of evaluations will likely be the focus of the resident's interaction with their assessments.