The RISE Assessment: A Tool to Evaluate Competencies in Patient Safety and Quality Improvement.

Background Medical schools and residency programs have increasingly established formal education and standardized curricula in patient safety and quality improvement. However, assessment of resident and fellow proficiency in these areas can be challenging. Our institution needed a tool with a broad scope of content and detailed competency levels. We therefore created the Rochester Improvement and Safety Education (RISE) Assessment. Objective To describe the development, structure, and implementation of the RISE Assessment and provide preliminary validity evidence, including feasibility of use. Methods The first axis of the tool consists of 4 domains divided into 8 subdomains and 52 content areas. The second axis utilizes a rubric, establishing consistent expectations for each proficiency level in an Accreditation Council for Graduate Medical Education Milestone-based format. A total of 1498 incoming and postgraduate year (PGY) 1-9 residents and fellows completed the RISE Assessment at least once between May 29, 2018, and August 30, 2022. This included incoming residents (N=418), PGY-1-4s (N=667), incoming fellows (N=120), and PGY-5-9s (N=293). Results Higher RISE scores were found for PGY-1-4s than incoming residents and for PGY-5-9s than incoming fellows. There was no difference in mean RISE scores between incoming fellows and PGY-1-4s. Analysis of a cohort of incoming residents (N=136) who completed the RISE Assessment upon starting their residency and then again at least 2 years later showed an increase in scores. Conclusions Higher proficiency scores with increasing PGY levels and with assessments performed by the same residents over time provide validity evidence for the RISE Assessment.