Evaluating medical residents’ literature-appraisal skills

Background. Measuring critical-appraisal skills is a key step in assessing physicians’ abilities to engage in self-directed learning. The authors developed an instrument to evaluate the abilities of residents to critically appraise a journal article. Method. In 1991, 62 residents in the categorical internal medicine program at the New England Medical Center were asked to respond to a questionnaire, evaluate a sample article, and complete a self-assessment of competence in evaluation of research. Critical-appraisal skill was determined by calculating the residents’ deviations from a “gold standard” critique developed through a modified Delphi technique, using a panel of five physicians. Spearman correlation coefficients were used to compare the residents’ actual and self-perceived abilities. Results. Twenty-eight residents returned the questionnaire, for a response rate of 45%. The composite score for the residents’ objective assessments was 63% of the gold standard, and was not significantly correlated with postgraduate year, prior journal club experience, or self-assessed critical-appraisal skill. Conclusion. After further validation in other settings, the assessment instrument in this study may be used to objectively assess critical-readίng skills. It may also provide feedback and measure outcomes for interventions designed to improve critical reading.