meaningful evaluation: framework, process, impact inis jane bardella, m.d., faafp associate dean for...
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Meaningful Evaluation:Framework, Process, Impact
Inis Jane Bardella, M.D., FAAFPAssociate Dean for Faculty Development and Global Health InitiativesDepartment of Family and Preventive Medicine
Lecia M. Apantaku, M.D., FACSAssistant Dean for Clinical Sciences EducationAssociate Professor, Department of Surgery
Chicago Medical SchoolRosalind Franklin University of Medicine and Science
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Objectives
Discuss the relationship between evaluation and learning.
Discuss a framework [RIME, Reporter Interpreter Manager Educator] for evaluation.
Discuss the process of evaluation. Apply the RIME framework to achieve
meaningful [accurate, useful, efficient] evaluation of students and residents.
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Vision
Effectively prepare medical students and residents to meet the health needs of the people of the United States [especially the poor] with compassion, integrity, high ethical standards and a high level of competence.
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Responsibility
Patients, always first Students and Residents Faculty
Clinical teachers – you Clerkship directorProgram director
Education systemCentegraCMS
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Definition
Process of making judgments based on factual information and observations in order to rate, rank or assess an individual’s status at a given point in time.
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Background – Adult Learning and Teaching
What is different about adults? Self-directed Goal-directed Application-oriented Competency concerns Shared responsibility Moral responsibility Teacher is: Resource, Facilitator, Mentor
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Background – Adult Learning and Teaching
How does this influence evaluation?
How should this influence evaluation?
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Bottom Line of Evaluation
Evaluation drives learning. Objectives determine evaluation. Evaluation is the second greatest fear
of preceptors/clinical faculty. Evaluation is absolutely necessary to
determine progression toward independent practice.
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So, why formal evaluation?
Summarize performance Determine competencies (behaviors) Guide future learning Communicate summary information Determine a grade
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Framework – RIME
Reporter Interpreter Manager Educator
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Framework – RIME
Reporter
Consistently professional, good interpersonal skills
Reliably obtains and communicates clinical findings
Ownership of clinical findings
Interpreter
Consistently able to analyze and prioritize patient problems
Ownership of explaining things
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Framework – RIME
Manager
Consistently proposes reasonable options incorporating patient preferences
Ownership of developing action plan with patient
Educator
Consistent level of knowledge of current medical evidence
Can critically apply knowledge to specific patients
Ownership of evidence for action and sharing
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RIME Caveat
Students must be reasonable, residents must be right.
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Application – RIME
What is the RIME?
How did you determine the RIME?
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Framework – RIME Synthetic model – synthesis
What we do all day long in patient care! Focus is patient – performance in relationship to
patient careProfessionalism requiredHigh level of interpersonal skills required
Descriptive Progressive, building model Competencies (KSA, behaviors) integral Not relative – Expectations clear
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A Few More RIME Caveats
Program must determine common problems and uncommon problems.
Program must determine core or essential areas and non-essential areas
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BREAK TIME
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Application
What is the RIME? What if:
Beginning 3rd year?Middle 3rd year?End 3rd year?Mid 4th year?Beginning intern?Mid intern?2nd year resident?
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Process – PIE Cycle
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Process - PIE
PlanningClerkship goals and objectivesRequirements/projectsStudent self-evaluateReview the form
Planning
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Process - PIE
InstructionObservationFeedbackAction plansGather and record data
• Patient and staff perceptions• Chart documentation• Observation• Student progress notes
Instruction
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Process - PIE
EvaluationForm
• Student• You
UnrushedEmphasize objectives, improvementSpecific commentsMeeting
Evaluation
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Comments about Comments
Examples? Demonstration Consistency Progression Improvement Recommendations RIME it
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Application - Forms
RIME the elements RIME the learner Complete the form using RIME as the
framework to assess behavior, i.g. competency.
Comments
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Summary
Evaluation is a continuous process. Evaluation drives learning. Goals & objectives determine evaluation. RIME it.
Determine the student’s starting point.Develop a plan for progression.Determine the final evaluation.
Include comments To teach is to learn again!
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ReferencesBardella IJ, ed. Essentials of precepting 2002-2003. 2002, revised 2006.
Ende, J. Feedback in clinical medical education. JAMA. 1983;250:777-781.
Massachusetts statewide area health education center program. Faculty development workbook. 1995.
Pangaro LN. A new vocabulary and other innovations for improving descriptive in-training evaluations. Acad Med. 1999;74:1203-1207.
Pangaro LN. Evaluating trainees in the clinical setting: what does competency in patient care look like? Presented 25 Jan 2012 at RFUMS, North Chicago, IL.
Society of teachers of family medicine pep2 committee. Preceptor education project, second edition: facilitators guide. Society of teachers of family medicine. Kansas City. 1999.