Clinical Assessment of Residents: A Survey of Clinician Educators Regarding Resident Assessment Burden and Modifiable Factors.

Background: A fundamental role of the clinician educator is to provide thoughtful assessments for resident development. A gap in the literature exists about whether the completion of assessments contributes to clinician educator burden.

Objective: We sought to understand the degree to which completing resident assessments contributes to clinician educator burden, the drivers behind such perception, and whether modifiable factors exist.

Methods: In October 2020, we conducted a cross-sectional study of adult hospital medicine clinician educators to explore burden associated with resident assessment. The authors developed a 10-item electronic survey (Likert type and sliding scale responses), asking about demographics, context, frequency and degree of burden, burdensome aspects of assessments, estimated time for assessments, and percentage of assessments turned in late or never. We conducted subgroup analyses for differences in responses based on sex and number of years practicing, and regression analyses for predictors of burden degree.

Results: Fifty of 81 (62%) surveyed faculty responded. Two percent (1 of 50) reported no burden, while 42% (21 of 50) reported infrequent ("never," "rarely," "sometimes") and 56% (28 of 50) reported frequent ("often," "always") burden. Of those experiencing burden, 67% (33 of 49) reported slight or moderate, and 33% (16 of 49) reported significant or extreme burden. Potentially modifiable causes included assessment request boluses, lag time between resident service and assessment requests, and technology involved. Female clinician educators estimated submitting a higher percentage of late assessments than males (65% vs 41%, =.02). Number of years practicing was inversely associated with assessment time (β=-0.28, =.01).

Conclusions: Our findings suggest that resident assessments are a source of burden among adult hospital medicine clinician educators and that several potentially modifiable factors may underlie this burden.