Original CommunicationThe nature of general surgery resident performance problems
Section snippets
Methods
We performed a retrospective record review of all (n = 78) general surgery categorical residents in 1 general surgery program since its inception in 1977 until completion of the 2005–06 academic year. Five primary data sources were reviewed for each resident: global numeric ratings and narrative evaluations of residents for each rotation, memoranda of record for advisor meetings with residents, minutes and other records of end-of-year decision meetings about resident progress, memoranda and
Inter-rater agreement
Three raters were used to evaluate records. For the 10 inter-rater agreement cases, all 3 raters agreed on the problem status (serious problems, no serious problems) for 7 of the 10 cases. Two raters agreed on the problem status for the other 3 cases. For 2 of the 10 cases, all 3 raters agreed there was no problem. Two of the raters agreed there was no problem for 2 additional cases. Therefore, the majority of raters agreed that there was no problem for 40% of the cases in the inter-rater
Discussion
In summary, we identified 17 cases (22%) where residents had serious, substantive performance problems during their training program. This finding is similar to that of Bergen et al,4 who reported a prevalence of 21% in another general surgery residency program.
Virtually all problems in our study proved to be chronic; they were still present at the end of training in every case where this could be determined. Reamy and Harman2 reported that attitudinal problems are “more refractory to
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