Using patients' charts to assess medical trainees in the workplace: a systematic review

Med Teach. 2015 Apr:37 Suppl 1:S82-7. doi: 10.3109/0142159X.2015.1006599. Epub 2015 Feb 4.

Abstract

Objectives: The objective of this review is to summarize and critically appraise existing evidence on the use of chart stimulated recall (CSR) and case-based discussion (CBD) as an assessment tool for medical trainees.

Methods: Medline, Embase, CINAHL, PsycINFO, Educational Resources Information Centre (ERIC), Web of Science, and the Cochrane Central Register of Controlled Trials were searched for original articles on the use of CSR or CBD as an assessment method for trainees in all medical specialties.

Results: Four qualitative and three observational non-comparative studies were eligible for this review. The number of patient-chart encounters needed to achieve sufficient reliability varied across studies. None of the included studies evaluated the content validity of the tool. Both trainees and assessors expressed high level of satisfaction with the tool; however, inadequate training, different interpretation of the scoring scales and skills needed to give feedback were addressed as limitations for conducting the assessment.

Conclusion: There is still no compelling evidence for the use of patient's chart to evaluate medical trainees in the workplace. A body of evidence that is valid, reliable, and documents the educational effect in support of the use of patients' charts to assess medical trainees is needed.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Clinical Competence*
  • Educational Measurement / methods*
  • Feedback
  • Humans
  • Internship and Residency / methods*
  • Learning
  • Medical Records*
  • Medicine
  • Reproducibility of Results
  • Workplace / organization & administration*