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Invited Commentary
May 2016

Use of a Structured Assessment to Measure Nontechnical Aspects of Otolaryngology Residency Training

Author Affiliations
  • 1Department of Otolaryngology–Head and Neck Surgery, Oregon Health Sciences University, Portland
JAMA Otolaryngol Head Neck Surg. 2016;142(5):429. doi:10.1001/jamaoto.2015.3910

An educational curriculum that produces competent clinicians is the cornerstone of all residency training programs. The development of this clinical expertise has many components. Some, such as knowledge acquisition, technical expertise, and experience, are more tangible and measurable. Others, such as clinical judgment and critical thinking, are more enigmatic and yet equally if not more important. The challenge of how to teach these less tangible attributes has confounded medical educators since Hippocrates and continues to do so. Lacking better definition, we as educators tend to rely on a “we know it when we see it” method of assessing our trainees’ progress in their acquisition. In general, there tends to be agreement among the faculty about resident expertise at the extremes: the residents we know will to do the right thing regardless of their level of training and the residents whose clinical decision-making we have difficulty trusting despite an adequate knowledge base. Sorting out the residents in between and defining the specific issues are that are impeding their progress along the clinical continuum is more difficult. To do better we need to be develop valid methods for measuring these “less tangible” qualities.