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Purpose Academic centers utilize web-based surveillance systems to administer their evaluations, but little is known about their impact on the evaluation responsibilities delegated to medical residents. Method Using a mixed-methods approach, a retrospective content analysis was conducted of the evaluation activities experienced by a cohort of 29 residents as they completed their training in general internal medicine from 2009-2012. These data were triangulated with group interviews conducted with current internal medicine residents in 2012-2013. Results The internal medicine program electronically requested that its residents complete 8,614 evaluation reports on clinical faculty, curriculum, and junior trainees (345 requests annually per resident). Residents reported feeling overwhelmed by their ongoing evaluation workload, and admitted that their motivation to submit high-quality appraisals was dissipating. Residents perceived that their program valued certain evaluations more than others, and this was a major factor in their decision regarding whether or not they would eventually submit an appraisal. Feedback submitted on program evaluation related appraisals were viewed as having the least value, and residents were significantly less likely to submit these evaluations. Conclusions Although web-based surveillance systems are efficient in distributing thousands of evaluations, residency programs to engage in ongoing vigilance of the unintended consequences associated with their use.
Jan 4 2017 (withdrawn)