End-of-Shift Evaluations: Experiences Over a Quarter-Century.

For the past 25 years, the San Antonio Uniformed Services Health Education Consortium (SAUSHEC) Emergency Medicine Residency has used an end-of-shift evaluation (ESE) to provide formative feedback and assess resident progress. The instrument has evolved from a simple half-sheet of paper to a more complex electronic milestones assessment. The length and detail of the evaluation form has grown appreciably, but the precise impact of these changes on the effectiveness of formative feedback unknown. The authors present a narrative description of the evolution of this instrument in response to changing requirements and efforts to optimize its utility. Our experiences over the past quarter-century are presented in the context of now-common utilization of similar evaluation tools among emergency medicine (EM) training programs. The evolution of our ESE instrument may be of historical interest to EM educators and provide examples for those seeking to develop or adapt their own evaluation tools.