Factors Important to Top Clinical Performance in Emergency Medicine Residency: Results of an Ideation Survey and Delphi Panel

Overview

Journal AEM Educ Train

Publisher Wiley

Specialty Emergency Medicine

Date 2018 Nov 3

PMID 30386836

Citations 12

Authors

Jesse M Pines

Sukayna Alfaraj

Sonal Batra

Caitlin Carter

Nisha Manikoth

Colleen N Roche

James Scott

Ellen F Goldman

Affiliations

Soon will be listed here.

Abstract

Objectives: We explore attributes, traits, background, skills, and behavioral factors important to top clinical performance in emergency medicine (EM) residency.

Methods: We used a two-step process-an ideation survey with the Council of Emergency Medicine Residency Directors and a modified Delphi technique-to identify: 1) factors important to top performance, 2) preresidency factors that predict it, and 3) the best ways to measure it. In the Delphi, six expert educators in emergency care assessed the presence of the factors from the ideation survey results in their top clinical performers. Consensus on important factors that were exemplified in >60% of top performers were retained in three Delphi rounds as well as predictors and measures of top performance.

Results: The ideation survey generated 81 responses with ideas for each factor. These were combined into 89 separate factors in seven categories: attributes, personal traits, emergency department (ED)-specific skills and behaviors, general skill set, background, preresidency predictors, and ways to measure top performance. After three Delphi rounds, the panel achieved consensus on 20 factors important to top clinical performance. This included two attributes, seven traits, one general skill set, and 10 ED-specific skills and behaviors. Interview performance was considered the sole important preresidency predictor and clinical competency committee results the sole important measure of top performance.

Conclusion: Our expert panel identified 20 factors important to top clinical performance in EM residency. Future work is needed to further explore how individuals learn and develop these factors.

Citing Articles

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References

Sobowale K, Ham S, Curlin F, Yoon J . Personality Traits Are Associated with Academic Achievement in Medical School: A Nationally Representative Study. Acad Psychiatry. 2017; 42(3):338-345. DOI: 10.1007/s40596-017-0766-5. View

Counselman F, Babu K, Edens M, Gorgas D, Hobgood C, Marco C . The 2016 Model of the Clinical Practice of Emergency Medicine. J Emerg Med. 2017; 52(6):846-849. DOI: 10.1016/j.jemermed.2017.01.040. View

Beeson M, Carter W, Christopher T, Heidt J, Jones J, Meyer L . The development of the emergency medicine milestones. Acad Emerg Med. 2013; 20(7):724-9. DOI: 10.1111/acem.12157. View

Duckworth A, Gross J . Self-Control and Grit: Related but Separable Determinants of Success. Curr Dir Psychol Sci. 2016; 23(5):319-325. PMC: 4737958. DOI: 10.1177/0963721414541462. View

Boyatzis R, Batista-Foguet J, Fernandez-I-Marin X, Truninger M . EI competencies as a related but different characteristic than intelligence. Front Psychol. 2015; 6:72. PMC: 4322617. DOI: 10.3389/fpsyg.2015.00072. View

Duvivier R, van Dalen J, Muijtjens A, Moulaert V, van der Vleuten C, Scherpbier A . The role of deliberate practice in the acquisition of clinical skills. BMC Med Educ. 2011; 11:101. PMC: 3293754. DOI: 10.1186/1472-6920-11-101. View

Boulkedid R, Abdoul H, Loustau M, Sibony O, Alberti C . Using and reporting the Delphi method for selecting healthcare quality indicators: a systematic review. PLoS One. 2011; 6(6):e20476. PMC: 3111406. DOI: 10.1371/journal.pone.0020476. View

Goldman E, Plack M, Roche C, Smith J, Turley C . Learning clinical versus leadership competencies in the emergency department: strategies, challenges, and supports of emergency medicine residents. J Grad Med Educ. 2012; 3(3):320-5. PMC: 3179228. DOI: 10.4300/JGME-D-10-00193.1. View

Pines J, Hilton J, Weber E, Alkemade A, Al Shabanah H, Anderson P . International perspectives on emergency department crowding. Acad Emerg Med. 2011; 18(12):1358-70. DOI: 10.1111/j.1553-2712.2011.01235.x. View

10.

Pines J, Alfaraj S, Batra S, Carter C, Manikoth N, Roche C . Factors Important to Top Clinical Performance in Emergency Medicine Residency: Results of an Ideation Survey and Delphi Panel. AEM Educ Train. 2018; 2(4):269-276. PMC: 6194040. DOI: 10.1002/aet2.10114. View

11.

Beeson M, Marco C, Nelson R, Korte R . Components of the model of the clinical practice of emergency medicine: a survey of American Board of Emergency Medicine diplomates. J Emerg Med. 2013; 44(6):1153-66. DOI: 10.1016/j.jemermed.2012.11.089. View

12.

McCLELLAND D . Testing for competence rather than for "intelligence". Am Psychol. 1973; 28(1):1-14. DOI: 10.1037/h0034092. View

13.

Bhat R, Takenaka K, Levine B, Goyal N, Garg M, Visconti A . Predictors of a Top Performer During Emergency Medicine Residency. J Emerg Med. 2015; 49(4):505-12. DOI: 10.1016/j.jemermed.2015.05.035. View

14.

Moore M, Bennett C . The learning curve for laparoscopic cholecystectomy. The Southern Surgeons Club. Am J Surg. 1995; 170(1):55-9. DOI: 10.1016/s0002-9610(99)80252-9. View

15.

Macleod M . What's a good doctor and how do you make one? How not to do it. BMJ. 2002; 325(7366):711; author reply 711. View

16.

Colmers-Gray I, Walsh K, Chan T . Assessment of emergency medicine residents: a systematic review. Can Med Educ J. 2017; 8(1):e106-e122. PMC: 5344063. View

17.

Wimmers P, Splinter T, Hancock G, Schmidt H . Clinical competence: general ability or case-specific?. Adv Health Sci Educ Theory Pract. 2006; 12(3):299-314. DOI: 10.1007/s10459-006-9002-x. View

18.

Considine J, Botti M, Thomas S . Do knowledge and experience have specific roles in triage decision-making?. Acad Emerg Med. 2007; 14(8):722-6. DOI: 10.1197/j.aem.2007.04.015. View

19.

Ericsson K . Deliberate practice and acquisition of expert performance: a general overview. Acad Emerg Med. 2008; 15(11):988-94. DOI: 10.1111/j.1553-2712.2008.00227.x. View

20.

Pines J, Lotrecchiano G, Zocchi M, Lazar D, Leedekerken J, Margolis G . A Conceptual Model for Episodes of Acute, Unscheduled Care. Ann Emerg Med. 2016; 68(4):484-491.e3. DOI: 10.1016/j.annemergmed.2016.05.029. View