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This article by Schueneman et al carefully analyzes the use of performance evaluations in a surgical training program. The importance of performance evaluations as demonstrated by this study relates to residents who were described either as a potential "problem" or as "superior." The majority of residents who were clustered in an "average" category did not correlate with final outcome evaluation. Since each of the dimensions predicted outcome particularly in the "problem" and "superior" groups, it should have been possible to identify residents early who might have needed remediation or special attention. Yet, 63 residents were considered a "problem" by at least one attending at the end of training. The excellent predictive value of their performance system would indicate that faculty, when properly instructed, can provide useful information that can assist in the decision making about resident progress.
The major drawback of the study is the lack of an independent outcome
Folse JR. Invited Commentary. Arch Surg. 1994;129(10):1073. doi:10.1001/archsurg.1994.01420340087016