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Differences between plastic surgery resident self-evaluations and attending assessments on ACGME Milestones
Amy Yao, Lester Silver, MD, Peter J. Taub, MD.
Icahn School of Medicine at Mount Sinai, New York, NY, USA.

Background
Resident assessment underwent a paradigm shift with the introduction of the Accreditation Council for Graduate Medical Education (ACGME)’s Next Accreditation System (NAS) in 2012. The new outcomes-based evaluation system is structured around a set of specialty-specific core competencies that are subdivided into individual milestones. Regular external feedback is vital for resident development, though a resident’s perception of their own progress may be of equal importance. Resident self-assessments can be useful to identify expectations and discrepancies in educational objectives, and may help maximize the success of their learning process. The objective of our study was to determine the correlation between milestone evaluation by plastic surgery faculty with resident self-evaluations.
Methods
This is a cross-sectional study of the first two years of NAS implementation of a single integrated six-year plastic surgery residency program. The program’s Clinical Competency Committee (CCC), comprised of eight faculty members, evaluated each resident in each of the milestones. Each resident then self-evaluated him/herself in the same milestones. We used sample t-tests to analyze the differences between the two sets of evaluations across the six PGYs, by individual milestone, and by core competency.
Results
Residents in PGY-1 and PGY-2 evaluated themselves significantly higher than their attendings in all six core competencies. By PGY-6, there was no significant difference between resident self-evaluations and attending evaluations. Average differences in scores generally decreased as PGY increased. Professional skills such as systems-based practice demonstrated the highest average difference in scores, especially in newer residents.
Conclusions
The gaps between attending evaluations and resident self-evaluations, particularly in the competencies describing professional skillsets, highlights the difference in faculty expectations and residents’ perception of their abilities. This study may be useful to further shape and validate the restructuring of the resident accreditation process.


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