Scrubbing Our Assessments: Using SOAP as a Template … · Scrubbing Our Assessments: Using SOAP as...
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Scrubbing Our Assessments: Using SOAP as a Template for OB/GYN Resident Evaluation 1 Kelley E. Whitehurst, MAEd • 1 Alyson P. Riddick, C-TAGME • 2 Heather Z. Sankey, MD • 1 Keith H. Nelson, MD 1 Vidant Medical Center • Brody School of Medicine at East Carolina University • Greenville, North Carolina 2 University of Massachusetts Medical School – Baystate • Springfield, MA Our aim was to create electronic evalua1on SOAP (eSOAP) Notes for use by the OB/GYN faculty to facilitate evalua1on comple1on and improve the quality of ac1onable feedback provided to the program’s residents and CCC, as well as increase resident sa1sfac1on with evalua1on and feedback received from faculty. Objectives Background Data from the 20142015 Accredita1on Council for Graduate Medical Educa1on (ACGME) Survey of Obstetrics and Gynecology (OB/GYN) residents at Vidant Medical Center (VMC) indicated resident dissa1sfac1on with the program’s evalua1on processes and the performance feedback they received. Simultaneously, the program’s Clinical Competency CommiSee (CCC) was struggling to evaluate resident achievement of Milestones due to a lack of data as the program’s one evalua1on form was vague and viewed by faculty as onerous. The VMC Graduate Medical Educa1on (GME) Office staff and the OB/GYN program director devised an improvement plan capitalizing on evalua1on skills faculty already possessed by employing the Subjec1ve Objec1veAssessmentPlan (SOAP) approach to pa1ent assessment within resident evalua1ons. While a literature review uncovered use of SOAP elements within overall program evalua1on and a connec1on to the ReporterInterpreterManagerEducator (RIME) components, there was liSle indica1on of SOAP element use as the template for resident evalua1on documents. The VMC GME staff and OB/GYN program director developed evalua1on ques1ons based on the program’s curriculum, specialty Milestones, and aSributes corresponding with the SOAP elements. These ques1ons were then systema1cally organized to create evalua1on forms, or eSOAP Notes, for each rota1on by training year. The eSOAP Note began with subjec1ve ques1ons primarily aimed at assessing Milestone progress in Prac1ceBased Learning and Improvement, Professionalism and Interpersonal and Communica1on Skills. Objec1ve ques1ons then followed, targe1ng topics in Pa1ent Care, Medical Knowledge, and SystemBased Prac1ce. A^er addressing these ini1al elements, the eSOAP Note transi1oned to an assessment of resident performance in regard to autonomy, faculty expecta1ons and rota1on objec1ves. The eSOAP Note concluded with an improvement plan in which faculty recommend an area the resident should focus on prior to the next rota1on or independent prac1ce. Methods Twentyseven unique eSOAP Notes were developed, which the program began u1lizing for resident evalua1on in July 2016. Fi^y eSOAP Notes were completed by faculty in the first two blocks of the 20162017 academic year, with 90% of those including specific, ac1onable feedback to the resident. By involving residents in the eSOAP Note development process, the 20152016 ACGME OB/GYN resident survey results regarding use of evalua1ons to improve the program increased from 26% to 81%, while resident sa1sfac1on with feedback a^er assignments increased from 21% to 67%. Results eSOAP Notes, which u1lize the SOAP pa1ent assessment approach faculty clearly understand, are one approach programs may employ when seeking to op1mize the clinical learning environment by providing ac1onable feedback. To ensure resident and faculty sa1sfac1on with a program’s evalua1on system, both must be included in evalua1on development and improvement. Significance Residents and faculty were provided dra^ eSOAP Notes with educa1on to promote a shared mental evalua1on model. The finalized eSOAP Notes were then entered into the ins1tu1on’s residency management system and mapped to the ACGME Milestones for CCC u1liza1on.
Transcript of Scrubbing Our Assessments: Using SOAP as a Template … · Scrubbing Our Assessments: Using SOAP as...
Scrubbing Our Assessments: Using SOAP as a Template for OB/GYN Resident Evaluation 1Kelley E. Whitehurst, MAEd • 1Alyson P. Riddick, C-TAGME • 2Heather Z. Sankey, MD • 1Keith H. Nelson, MD
1Vidant Medical Center • Brody School of Medicine at East Carolina University • Greenville, North Carolina 2University of Massachusetts Medical School – Baystate • Springfield, MA
Our aim was to create electronic evalua1on SOAP (eSOAP) Notes for use by the OB/GYN faculty to facilitate evalua1on comple1on and improve the quality of ac1onable feedback provided to the program’s residents and CCC, as well as increase resident sa1sfac1on with evalua1on and feedback received from faculty.
Objectives
Background
Data from the 2014-‐2015 Accredita1on Council for Graduate Medical Educa1on (ACGME) Survey of Obstetrics and Gynecology (OB/GYN) residents at Vidant Medical Center (VMC) indicated resident dissa1sfac1on with the program’s evalua1on processes and the performance feedback they received. Simultaneously, the program’s Clinical Competency CommiSee (CCC) was struggling to evaluate resident achievement of Milestones due to a lack of data as the program’s one evalua1on form was vague and viewed by faculty as onerous.
The VMC Graduate Medical Educa1on (GME) Office staff and the OB/GYN program director devised an improvement plan capitalizing on evalua1on skills faculty already possessed by employing the Subjec1ve-‐Objec1ve-‐Assessment-‐Plan (SOAP) approach to pa1ent assessment within resident evalua1ons. While a literature review uncovered use of SOAP elements within overall program evalua1on and a connec1on to the Reporter-‐Interpreter-‐Manager-‐Educator (RIME) components, there was liSle indica1on of SOAP element use as the template for resident evalua1on documents.
The VMC GME staff and OB/GYN program director developed evalua1on ques1ons based on the program’s curriculum, specialty Milestones, and aSributes corresponding with the SOAP elements. These ques1ons were then systema1cally organized to create evalua1on forms, or eSOAP Notes, for each rota1on by training year.
The eSOAP Note began with subjec1ve ques1ons primarily aimed at assessing Milestone progress in Prac1ce-‐Based Learning and Improvement, Professionalism and Interpersonal and Communica1on Skills. Objec1ve ques1ons then followed, targe1ng topics in Pa1ent Care, Medical Knowledge, and System-‐Based Prac1ce. A^er addressing these ini1al elements, the eSOAP Note transi1oned to an assessment of resident performance in regard to autonomy, faculty expecta1ons and rota1on objec1ves. The eSOAP Note concluded with an improvement plan in which faculty recommend an area the resident should focus on prior to the next rota1on or independent prac1ce.
Methods
Twenty-‐seven unique eSOAP Notes were developed, which the program began u1lizing for resident evalua1on in July 2016. Fi^y eSOAP Notes were completed by faculty in the first two blocks of the 2016-‐2017 academic year, with 90% of those including specific, ac1onable feedback to the resident.
By involving residents in the eSOAP Note development process, the 2015-‐2016 ACGME OB/GYN resident survey results regarding use of evalua1ons to improve the program increased from 26% to 81%, while resident sa1sfac1on with feedback a^er assignments increased from 21% to 67%.
Results
eSOAP Notes, which u1lize the SOAP pa1ent assessment approach faculty clearly understand, are one approach programs may employ when seeking to op1mize the clinical learning environment by providing ac1onable feedback. To ensure resident and faculty sa1sfac1on with a program’s evalua1on system, both must be included in evalua1on development and improvement.
Significance
Residents and faculty were provided dra^ eSOAP Notes with educa1on to promote a shared mental evalua1on model. The finalized eSOAP Notes were then entered into the ins1tu1on’s residency management system and mapped to the ACGME Milestones for CCC u1liza1on.
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