Daily Encounter Cards—Evaluating the Quality of Documented Assessments

Abstract

ABSTRACT Background  Concerns over the quality of work-based assessment (WBA) completion has resulted in faculty development and rater training initiatives. Daily encounter cards (DECs) are a common form of WBA used in ambulatory care and shift work settings. A tool is needed to evaluate initiatives aimed at improving the quality of completion of this widely used form of WBA. Objective  The completed clinical evaluation report rating (CCERR) was designed to provide a measure of the quality of documented assessments on in-training evaluation reports. The purpose of this study was to provide validity evidence to support using the CCERR to assess the quality of DEC completion. Methods  Six experts in resident assessment grouped 60 DECs into 3 quality categories (high, average, and poor) based on how informative each DEC was for reporting judgments of the resident's performance. Eight supervisors (blinded to the expert groupings) scored the 10 most representative DECs in each group using the CCERR. Mean scores were compared to determine if the CCERR could discriminate based on DEC quality. Results  Statistically significant differences in CCERR scores were observed between all quality groups (P < .001). A generalizability analysis demonstrated the majority of score variation was due to differences in DECs. The reliability with a single rater was 0.95. Conclusions  The CCERR is a reliable and valid tool to evaluate DEC quality. It can serve as an outcome measure for studying interventions targeted at improving the quality of assessments documented on DECs.