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Evaluating the performance of inpatient attending physicians

A new instrument for today’s teaching hospitals

  • Innovations In Education And Clinical Practice
  • Published:
Journal of General Internal Medicine Aims and scope Submit manuscript

Abstract

OBJECTIVE: Instruments available to evaluate attending physicians fail to address their diverse roles and responsibilities in current inpatient practice. We developed a new instrument to evaluate attending physicians on medical inpatient services and tested its reliability and validity.

DESIGN: Analysis of 731 evaluations of 99 attending physicians over a 1-year period.

SETTING: Internal medicine residency program at a university-affiliated public teaching hospital.

PARTICIPANTS: All medical residents (N=145) and internal medicine attending physicians (N=99) on inpatient ward rotations for the study period.

MEASUREMENTS: A 32-item questionnaire assessed attending physician performance in 9 domains: evidence-based medicine, bedside teaching, clinical reasoning, patient-based teaching, teaching sessions, patient care, rounding, professionalism, and feedback. A summary score was calculated by averaging scores on all items.

RESULTS: Eighty-five percent of eligible evaluations were completed and analyzed. Internal consistency among items in the summary score was 0.95 (Cronbach’s α). Interrater reliability, using an average of 8 evaluations, was 0.87. The instrument discriminated among attending physicians with statistically significant differences on mean summary score and all 9 domain-specific mean scores (all comparisons, P<.001). The summary score predicted winners of faculty teaching awards (odds ratio [OR], 17; 95% confidence interval [CI], 8 to 36) and was strongly correlated with residents’ desire to work with the attending again (r=.79; 95% CI, 0.74 to 0.83). The single item that best predicted the summary score was how frequently the physician made explicit his or her clinical reasoning in making medical decisions (r2=.90).

CONCLUSION: The new instrument provides a reliable and valid method to evaluate the performance of inpatient teaching attending physicians.

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Authors and Affiliations

  1. Received from the Department of Medicine, Cook County Hospital and Rush Medical College, Chicago, Ill

    Christopher A. Smith MD, Anita B. Varkey MD, Arthur T. Evans MD, MPH & Brendan M. Reilly MD

Authors
  1. Christopher A. Smith MD
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  2. Anita B. Varkey MD
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  3. Arthur T. Evans MD, MPH
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  4. Brendan M. Reilly MD
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Corresponding author

Correspondence to Christopher A. Smith MD.

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Financial support came from the Department of Medicine, Cook County Hospital.

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Smith, C.A., Varkey, A.B., Evans, A.T. et al. Evaluating the performance of inpatient attending physicians. J GEN INTERN MED 19, 766–771 (2004). https://doi.org/10.1111/j.1525-1497.2004.30269.x

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  • DOI: https://doi.org/10.1111/j.1525-1497.2004.30269.x

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