Group assessments of resident physicians improve reliability and decrease halo error

J Gen Intern Med. 2011 Jul;26(7):759-64. doi: 10.1007/s11606-011-1670-4. Epub 2011 Mar 3.


Background: Individual faculty assessments of resident competency are complicated by inconsistent application of standards, lack of reliability, and the "halo" effect.

Objective: We determined whether the addition of faculty group assessments of residents in an ambulatory clinic, compared with individual faculty-of-resident assessments alone, have better reliability and reduced halo effects.

Design: This prospective, longitudinal study was performed in the outpatient continuity clinics of a large internal medicine residency program.

Main measures: Faculty-on-resident and group faculty-on-resident assessment scores were used for comparison.

Key results: Overall mean scores were significantly higher for group than individual assessments (3.92 ± 0.51 vs. 3.83 ± 0.38, p = 0.0001). Overall inter-rater reliability increased when combining group and individual assessments compared to individual assessments alone (intraclass correlation coefficient, 95% CI = 0.828, 0.785-0.866 vs. 0.749, 0.686-0.804). Inter-item correlations were less for group (0.49) than individual (0.68) assessments.

Conclusions: This study demonstrates improved inter-rater reliability and reduced range restriction (halo effect) of resident assessment across multiple performance domains by adding the group assessment method to traditional individual faculty-on-resident assessment. This feasible model could help graduate medical education programs achieve more reliable and discriminating resident assessments.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Analysis of Variance
  • Clinical Competence / standards*
  • Education, Medical, Graduate / methods*
  • Education, Medical, Graduate / standards
  • Educational Measurement*
  • Humans
  • Internal Medicine / education*
  • Internship and Residency / standards*
  • Longitudinal Studies
  • Peer Group*
  • Prospective Studies
  • Reproducibility of Results