EVALUATION OF RESIDENT PROGRESS
The residency program uses the Allied Health Student Tracking (AHST) System to track and evaluate the resident’s progress through the program using consistent and well-defined metrics. The software facilitates the evaluation of the resident’s strengths and areas for improvement, as well as keeps track of the resident’s accomplishments.
Expectations for resident performance and institutional disciplinary procedures are reviewed with the resident at their initial meeting with the Program Director. The resident is also provided a copy of the resident handbook that details these expectations and procedures. Evaluation of the resident’s progress through the program is performed through meetings with the Program Director and rotation advisor, rotation evaluations, oral exams, and annual testing.
During each clinical rotation, rotation advisors are assigned and available to the resident. The advisors monitor the resident’s progress and provide guidance throughout the rotation. In order to monitor the resident’s progress, the residents submit weekly progress reports to their rotation advisor. These reports list the clinical, didactic, and professional activities that the resident has observed or performed that week. Weekly progress (case log) reports are completed via the AHST System.
Weekly meetings between the resident and the rotation advisor are held to review these logs and assess the resident’s progress in the current rotation. The resident will often be asked to explain procedures and skills they recently completed in order to provide a subjective evaluation of the resident’s clinical reliability and understanding of these concepts. These meetings are also meant to discuss problems related to resident training and to provide mentoring as required.
Resident progress is also assessed monthly through meetings with the Program Director. During this meeting, the monthly progress report completed via the AHST System is reviewed to ensure the resident is still on track for rotation completion within the scheduled timeframe. Comments made by the Program Director are logged in this survey completed via the AHST System and used to keep track of any items needing additional focus, as well as any changes that may have been made to the resident’s course.
At the end of each rotation, the rotation advisor evaluates the performance of the resident during the rotation against the expectations and competencies required for that rotation. The evaluation takes place based on both the scheduled end of rotation oral exam and the overall performance during the rotation. The evaluation is submitted through a survey via the AHST System. The resident is evaluated on clinical knowledge and application, learning and development, as well as components of clinical performance which include professionalism, attitude, work ethic, communication skills, successful execution of tasks, and areas requiring improvement.
At the end of each rotation, the resident is given a rigorous oral exam which provides a direct assessment of the resident’s progress and performance. The one-hour exam not only consists of questions pertaining to the given rotation, but also contains comprehensive questions to provide an ongoing evaluation of the resident’s progress. The oral exams follow the ABR part 3 certification exam categories and are very similar in content based on the experience of staff physicists, of which several have served as examiners. The oral exam is administered by the rotation advisor and attended by all physics staff. Examinees are asked to provide a score for each question, as well as feedback on which topics they believe the resident must review in more depth. The examinees also evaluate the residents on their board etiquette in order to better prepare them for the board examination.
At the end of the exam, the examining committee grades the candidate in a private session and the final grade is the average grade for all examiners. The committee also creates a list of lookups to remediate any areas that the examiners recommend. After every examination, the rotation advisor debriefs the resident, and areas of improvement in terms of subject knowledge and examination techniques are discussed. The resident then has a week following the exam to perform their list of which they will then review with the rotation advisor in order to consider the rotation successfully complete.
If a resident does not pass an oral exam, a remediation plan is put into place to address deficiencies that were found in the oral exam. The remediation plan is constructed with the Program Director and the Director of Physics. This will be tailored to the resident’s deficiencies and may include remedial readings, additional clinical tasks to complete, reviews of materials with physicists, and retake of the failed oral exam. The remediation plan will be given an appropriate deadline based on the amount of remediation needed (on the order of a few weeks). Once the remediation plan is complete, the resident will then continue to the next rotation after a successful retake of previous exam.
In addition to the end of rotation oral exams, the resident is required to take two written exams during their residency. The written exam is the RAPHEX Therapy Examination and is administered in May or June of each year. Following the exam, the Program Director will review the questions missed by each resident. While not a formal part of the program evaluation process, results of the RAPHEX exam are used as an objective evaluation of the resident’s knowledge relative to a national sample of the medical physics community. They are also used as a means of preparing the resident for ABR Part 2.
In order to improve and update the residency program on an ongoing basis, residents are continuously asked to provide feedback throughout their two-year journey. The resident is asked to evaluate components of the program, including learning opportunities, staff availability, effectiveness of educational experience, adherence to program objectives, and areas requiring improvement. There are several mechanisms for feedback, including one-on-one meetings with the Program Director and rotation advisor, end-of-rotation evaluations, end-of-program evaluations, and through report to the senior resident who then reports to the residency program steering committee.
At the end of each rotation, residents complete a survey submitted through the AHST System. The resident is asked to evaluate the content of the clinical rotation and assesses the rotation mentor as well as any physicists that provided direct oversight for clinical projects completed. In order to protect residents from retribution related to their feedback, the survey has the option for anonymous submission. These evaluations provide a mechanism for the residents to share their thoughts on how the rotations and mentoring could be improved. Additionally, at the end of the residency program, program graduates are asked to evaluate the entire program on its weaknesses and strengths and make suggestions for improvement.
The resident can present his/her evaluations of the program and to address areas that require improvement by reporting feedback to the senior resident or by submitting an anonymous program evaluation in the AHST System. The senior resident attends all residency steering committee meetings to act as the residency representative . An opportunity is provided in the meeting for the senior resident to provide direct feedback to the committee, bringing forth any residents’ issues and concerns and thereby providing a mechanism for all residents to communicate with the steering committee. The committee reviews the program evaluations, rotation and advisor evaluations, and feedback provided by the senior resident to determine whether program modifications are necessary to improve resident learning.