Resident Individual Clinical Evaluations: Resident Perspectives And Effectiveness

Introduction

Senior residents near the end of their training must be prepared to start an independent practice. To become board-certified they must pass an oral exam, the ABS Certifying Exam (ABSCE). Prior work has introduced the resident Individual Clinical Evaluations (rICE), a low-cost tool developed to assess residents' clinical judgment in level-appropriate clinical scenarios. rICE is a comprehensive program/curriculum that supports residents in preparing for their ABSCE. We evaluated residents' perceived utility of the rICE, present curricular components, and compared mock oral and ABSCE pass rates.

Design

PGY1-3 surgical residents completed 3 level-appropriate rICE per AY. Immediate feedback was provided after each encounter. After passing all scenarios, residents were invited to take a post-rICE survey on their perceived curriculum utility. A mixed methods approach was used for data analysis.

Setting

This study occurred at an academic tertiary care center in Boston, Massachusetts, USA.

Participants

All PGY1-3 surgical residents between AY 2016–2020 were eligible to participate.

Results

We collected 102 post-rICE surveys. Most trainees agreed that they felt better prepared to manage the evaluated clinical scenarios after rICE (81.37%), that these evaluations were an outstanding learning experience (87.25%), and that they would recommend the curriculum to other residents (85.29%). Relevant free-text comments were favorable toward the utility of this curriculum. rICE participants had an increase in mock orals pass rates over time (trending towards significance; p ≈ 0.06), and a 44% absolute increase in ABSCE pass rates (p ≈ 0.01) compared to non-rICE participants.

Conclusion

Residents had a favorable impression of rICE; offering an adaptable and implementable curriculum that provides a platform for self-reflection on their knowledge base and presentation skills. rICE is sustainable and low-resource intensive, providing residents early exposure to face-to-face clinical evaluations, and was associated with improved board pass rates, and possibly improved mock oral pass rates (although not statistically significant).