Rules of Engagement: Residents’ Perceptions of the In-Training Evaluation Process
Abstract
BACKGROUND: In-training evaluation reports (ITERs) often fall short of their goals of promoting resident learning and development. Efforts to address this problem through faculty development and assessment-instrument modification have been disappointing. The authors explored residents' experiences and perceptions of the ITER process to gain insight into why the process succeeds or fails. METHOD: Using a grounded theory approach, semistructured interviews were conducted with 20 residents. Constant comparative analysis for emergent themes was conducted. RESULTS: All residents identified aspects of "engagement" in the ITER process as the dominant influence on the success of ITERs. Both external (evaluator-driven, such as evaluator credibility) and internal (resident-driven, such as self-assessment) influences on engagement were elaborated. When engagement was lacking, residents viewed the ITER process as inauthentic. CONCLUSIONS: Engagement is a critical factor to consider when seeking to improve ITER use. Our articulation of external and internal influences on engagement provides a starting point for targeted interventions.
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Timeliness is important to learners' acceptance and use of feedback.
“Studies of learners’ perceptions of effective feedback have highlighted the importance of timeliness to learners’ acceptance and use of feedback [7, 11]”
From Guidelines: The do’s, don’ts and don’t knows of feedback for clinical education. (2015) · cites this paper as [11]
Trainees may begin to devalue external feedback in general, relying instead on self-assessment, as a consequence of poor-quality feedback.
“As a consequence, trainees may begin to devalue external feedback in general, relying instead on self-assessment [10, 11].”
From Guidelines: The do’s, don’ts and don’t knows of feedback for clinical education. (2015) · cites this paper as [11]
The quality of feedback received in medical training is often reported as low and poorly informed due to factors including limited direct observation of performance.
“In reality, however, the quality of the feedback received in medical training is often reported as low, and poorly informed due to factors including limited direct observation of performance.”
From Guidelines: The do’s, don’ts and don’t knows of feedback for clinical education. (2015) · cites this paper as [11]
Feedback works best soon after the event, especially for a complex task such as consulting with a patient.
“One explanation is that feedback works best soon after the event, especially for a complex task such as consulting with a patient [11, 13].”
From Guidelines: The do’s, don’ts and don’t knows of feedback for clinical education. (2015) · cites this paper as [11]
Factors such as the emotional reaction of the learner, the credibility of the educator, or the time interval within which feedback is given may all affect how learners perceive and interpret the feedback message.
“Other factors -such as the emotional reaction of the learner, the credibility of the educator, or the time interval within which feedback is given -may all affect how learners perceive and interpret the feedback message. 14,18-21”
From Medical student perceptions of feedback and feedback behaviors within the context of the “educational alliance.” (2017) · cites this paper as [18]
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- Authors
- Watling, C. J., Kenyon, C. F., Zibrowski, E. M., Schulz, V., Goldszmidt, M. A., Singh, I., Maddocks, H. L., & Lingard, L.
- Affiliations
- London Health Sciences Centre (CA)
- Corresponding author
- Watling, Christopher J.
- ORCID
- Venue
- Academic Medicine
- Publisher
- Oxford University Press (OUP)
- Published
- 2008-10
- Volume
- 83
- Issue
- Supplement
- Pages
- S97-S100
- ISSN
- 1040-2446 (ISSN-L)
- OpenAlex
- W1994774607
- Cited by
- 86
- References
- 14
- Citations by year
- 2026: 4 · 2025: 1 · 2024: 3 · 2023: 3 · 2022: 4 · 2021: 4 · 2020: 8 · 2019: 7 · 2018: 7 · 2017: 10 · 2016: 3 · 2015: 8 · 2014: 6 · 2013: 4 · 2012: 4
- FWCI
- 3.30
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Academic Medicine (publishedVersion)
- PubMed (publishedVersion)
- Scholarship@Western (Western University) (submittedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Innovations in Medical Education
- Social Sciences › Education › Student Assessment and Feedback
- Social Sciences › Education › Evaluation of Teaching Practices
- Keywords
- graduate medical education, resident perceptions, resident engagement, self-assessment, faculty development
- MeSH terms
- Attitude of Health Personnel, Educational Measurement, Female, Humans, Inservice Training, Internship and Residency, Interprofessional Relations, Interviews as Topic, Knowledge of Results, Psychological, Male, Reproducibility of Results, Cohort Studies, Program Evaluation
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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