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How do Emergency Medicine Attending Physicians Evaluate their Trainees? A Multicenter Focus Group Study

Abdulmohsen Alsaawi, Mishal Almarshady, Abdullah Alzabin, Abdullah Alanazi, Majid Alsalamah and Mohammed Alsultan

Background: In-training evaluations have an invaluable role in assessing the clinical competency of the trainee. In this study, we explore which trainees’ characteristics have the strongest impact on their evaluation and whether these characteristics fit in the Royal College of Physicians and Surgeons of Canada's CanMEDS Physician Competency Framework. Based on the seven roles that physicians need to have, the framework describes the capabilities that physicians need to produce better patient outcomes. Methods: Emergency medicine attending physicians involved in supervising residents at the four main emergency medicine residency training sites in Riyadh, Saudi Arabia participated in focus group sessions to identify resident characteristics most frequently noted and their impact on the overall evaluation. The interview process followed a standard format. All interviews were audiotaped, and field notes were taken. Two independent coders coded the interviews using CanMEDS competencies as a framework. The frequency of each mention of a particular characteristic was recorded. Following the interviews, participants were also asked to complete a questionnaire about the CanMEDS competencies they routinely or rarely assess. Results are presented in a descriptive fashion. Results: A total of six focus groups sessions were held with 19 participants. The focus group sessions yielded a total of 145 features, or characteristics. Characteristics relating to medical expertise competencies had the strongest impact, followed by professionalism-related competencies, while characteristics relating to health advocacy and managerial skills had the weakest impact on the evaluation. Conclusion: Our results are consistent with previous literature in showing that evaluators tend to base their evaluations on certain competencies and fail to evaluate competencies across the entire CanMEDS spectrum.