The Resident, the Student, and the Competencies: A guide on how to use the competencies as criteria for evaluating faculty-resident-student interaction

Barry D. Mann, MD, Paula M. Termuhlen, MD, and Michael Ujiki, MD 

During the 2005 Surgical Education Week in New York City, the Association for Surgical Education (ASE) and Association for Program Directors in Surgery (APDS) cosponsored a program for students and residents entitled, The Resident, the Student, and the Competencies. Thirty medical schools sent resident-student pairs to participate in the project. 

During the course of their three days at the meeting, resident-student pairs participated in three special student-resident sessions in which the objectives were to consider the ACGME Competencies from the point of view of the student and resident.  They worked together to develop a compilation within each competency of "best resident-student interactions" and "resident-student interactions to be avoided." 

In preparation for the meeting, the resident-student pair was required to brainstorm together to list within each competency three "best behaviors" and three "behaviors which should be avoided."  When combined, these lists (compiled from the 30 student-resident pairs) contained 75-90 ideas of "bests" and "avoids" within each competency.  These lists were collated into a resource book for the student-resident participants at the ASE/APDS meeting. 

The first student-resident session was introduced by ASE and APDS members who defined core definitions of the competencies from a surgeon's viewpoint and rendered personal statements addressing the "value of the particular competency to me as a surgeon."  The faculty participants also offered examples of behaviors for which "I give kudos" and behaviors for which "I would call a resident/student into the office for discussion!" 

To ascertain that participants had a relatively unified understanding of the intent and scope of the competencies, students and residents next met in small groups with faculty facilitators to discuss specific ethical dilemmas (contributed by the participants prior to the meeting) in light of the competencies as they had been defined.

The resident-student discussion on day two of the conference convened immediately following David Leach's keynote address on the Formation of Surgical Residents: Competence and Character.  Students and residents again met in small groups to select from the previously compiled lists what they considered to be the 10-15 most important "bests" and "avoids" in each competency.  These selections were assembled into PowerPoint presentations and subsequently presented and discussed over breakfast on day three of this event. 

The result of this exercise represents a student-resident translation of abstract competency definitions into concrete behaviors at the student-resident level and reflects the trainee's view from the educational trenches. 

The lists of behaviors which resulted demonstrate that there is a natural overlap in the competencies, as numerous "ideal behaviors" and "behaviors to avoid" were repeated in more than one competency.  The need to demonstrate respect for ancillary hospital personnel, for example, was considered as a positive behavior in communication and interpersonal skills, professionalism, and the system-based competency.  

For the purpose of this Web article, the compiled lists of exemplary behaviors and behaviors to be avoided were re-worked into a checklist format.  It is our hope that these checklists will be helpful to residents and program directors in using the competencies as criteria for evaluating the dynamic of faculty-resident-student interaction on the surgical service.  These checklists can be used for self-evaluation, peer evaluation, 360 degree evaluation, and/or faculty evaluation. 

• Checklist for Role-modeling Behaviors Associated with PATIENT CARE (60K PDF)

• Checklist for Role-modeling Behaviors Associated with MEDICAL KNOWLEDGE (40K PDF)

• Checklist for Role-modeling Behaviors Associated with PROFESSIONALISM (30K PDF)

• Checklist for Role-modeling Behaviors Associated with COMMUNICATION AND INTERPERSONAL SKILLS (30K PDF)

• Checklist for Role-modeling Behaviors Associated with PRACTICE-BASED IMPROVEMENT (45K PDF)

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With thanks to the members of the ASE and APDS who served as facilitators

Institution	Resident Name	Student Name
Albany Medical College	Saum Rahimi	Adi Abramovici
Brigham and Women's Hosp.	Jake Greenberg	Eric Sheu
Columbia University	Steve Xydas	John Kirkham
Indiana University	Jennifer Choi	Alyssa Wait
Johns Hopkins	Michael Awad	Kelly Olino
Lankenau Hospital	Ryan Hoffman	Kathryn Pool
McMaster University	Yvonne Ying	Navjot Chaudhary
Medical College of Georgia	Adeline Deladisma	Christopher Killingsworth
Mount Sinai - New York	Scott Nguyen	Linda Zhang
Northwestern University	Mike Ujiki	Ben Levi
Penn State	Tamer Ahmed	Rouzbeh Daylami
Rush University Med. Center	Edward Hollinger	Catherine Pesce
Stanford University	Anthony Carfelli	Catherine Mohr
SUNY Downstate	Sajani Shah	Sean Rim
Thomas Jefferson University	Niels Martin	Carson Campe
Univ. of Illinois - Chicago	Adnan Alseidi	Noam Belkind
Univ. of Illinois - Peoria	Jennifer Ash	Steven Tsoraides
Univ. of Southern California	Robert Kim	Vince Nguyen
University of New Mexico	Libby Watch	unable to attend
University of Oklahoma	Stephanie Dreiling	Amber Wooten
University of Rochester	Dina Elaraj	Derek Masden
University of Texas - Galveston	Brittany DeBerry	Kanika Bowen
University of Texas - Houston	Sam Atallah	Marshall Smith
University of Virginia	Brendon Stiles	Ann Vaughters
University of Wisconsin	Ann O'Rourke	Sandeepa Musunuru
Virginia Commonwealth Univ.	Jennifer Reed	Nicole Kissane
Washington University	Jeremy Goodman	Gita Mody
Wright State University	Thomas Stamp	Shannon Armstrong

With thanks to the members of the ASE and APDS who served as facilitators
for The Resident, the Student, and the Competencies

Linnea Hauge, PhD	David Rogers, MD, FACS
Kim Anderson, PhD	John Kairys, MD, FACS
Susan Kaiser, MD, PhD, FACS	Kim Ephgrave, MD, FACS
Pam Rowlands, PhD	R. Matthew Walsh, MD, FACS
Reed Williams, PhD	Walter Pofahl, MD, FACS
Sean Harbison, MD, FACS	Chris Brandt, MD, FACS
Hilary Sanfey, MD, FACS	Robert Noone, MD, FACS
Phillip Wolfson, MD, FACS	Thomas Lynch, MD, FACS
Joel Rosenfeld, MD, FACS	Rebecca Evangelisti, MD

Revised January 31, 2006