Resident progress is primarily assessed through their completion of tasks in the qualification card. The qualification card is given to the resident during orientation and can be specifically tailored to the individual resident if necessary. It spells out the required assignments, readings, clinical projects, reports, and exams necessary for the successful completion of a particular rotation. The qualification card contains sign-offs for all items that the resident must complete throughout the program. It is organized by rotation, requiring the supervising physicist or program director’s signature in order to consider the item successfully complete.
In addition to the qualification card, resident progress is monitored through the program by the assigned rotation advisor and the program director using evaluations that are based on clinical performance. The components of clinical performance include professionalism, attitude, work ethics, interpersonal communication skills, expected progress, successful execution of tasks, knowledge, and areas requiring improvement.
Each resident is required to maintain electronic weekly logs detailing their daily activities and amount of time spent on each item. 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 qualification card items 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 using a monthly progress report form that the resident prepares and reviews with the program director or rotation advisor at scheduled monthly meetings. This form provides assessment of the resident’s progression through the qualification card, conferences attended, and clinical responsibilities assigned and completed by the resident over the past month. Comments made by the rotation advisor or program director are logged in this file 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.
Approximately quarterly, and corresponding to the completion of a 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 given by all the staff physicists who can attend. 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 look-ups, which they will then review with the rotation advisor in order to consider the rotation successfully complete.
In the event that 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 on to the next rotation after a successful retake of the previous exam.
In addition to the evaluations described above, the residents will sit for the annual RAPHEX examination in June of both years of residency. 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, anonymous online surveys, 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 rotation assessment that is submitted to the Program Director. The resident is asked to evaluate the content of the clinical rotation and assesses the rotation mentor as well as any physicists who provided direct oversight for clinical projects completed. In order to protect residents from retribution related to their feedback, an anonymous online survey was created to allow residents to report feedback at any time during the residency. 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 has the opportunity to present his/her evaluations of the program and to address areas that require improvement by reporting all feedback to the senior resident who is invited to attend all residency steering committee meetings and act as the resident 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. All the resident-provided feedback is then reviewed by the committee and any areas requiring improvement can be addressed by making modifications to the program that may be necessary in order to enhance resident learning.