Shared Mental Models Among Clinical Competency Committees in the Context of Time-Variable, Competency-Based Advancement to Residency

Alan Schwartz, Dorene F. Balmer, Emily Borman-Shoap, Alan Chin, Duncan Henry, Bruce E. Herman, Patricia Hobday, James H. Lee, Sara Multerer, Ross E. Myers, Keith Ponitz, Adam Rosenberg, Jennifer B. Soep, Daniel C. West, Robert Englander

Research output: Contribution to journalArticlepeer-review

7 Scopus citations


Purpose To evaluate response process validity evidence for clinical competency committee (CCC) assessments of first-year residents on a subset of General Pediatrics Entrustable Professional Activities (EPAs) and milestones in the context of a national pilot of competency-based, time-variable (CBTV) advancement from undergraduate to graduate medical education. Method Assessments of 2 EPAs and 8 milestones made by the trainees' actual CCCs and 2 different blinded "virtual" CCCs for 48 first-year pediatrics residents at 4 residency programs between 2016 and 2018 were compared. Residents had 3 different training paths from medical school to residency: time-variable graduation at the same institution as their residency, time-fixed graduation at the same institution, or time-fixed graduation from a different institution. Assessments were compared using ordinal mixed-effects models. Results Actual CCCs assigned residents higher scores than virtual CCCs on milestones and one EPA's supervision levels. Residents who graduated from a different institution than their residency received lower milestone ratings than either group from the same institution; CBTV residents received higher ratings on one milestone (ICS4) and similar ratings on all others compared with non-CBTV residents who completed medical school at the same institution. Conclusions First-year residents who graduated from CBTV medical school programs were assessed as having the same level of competence as residents who graduated from traditional medical school programs, but response process evidence suggests that members of CCCs may also draw on undocumented personal knowledge of the learner to draw conclusions about resident competence.

Original languageEnglish (US)
Pages (from-to)S95-S102
JournalAcademic Medicine
Issue number11
StatePublished - Nov 1 2020

Bibliographical note

Publisher Copyright:
© 2020 Lippincott Williams and Wilkins. All rights reserved.


  • Clinical Competence/standards
  • Education, Medical, Undergraduate/standards
  • Internship and Residency/standards
  • Models, Psychological
  • Time Factors

PubMed: MeSH publication types

  • Research Support, Non-U.S. Gov't
  • Journal Article
  • Comparative Study


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