How can residency programs be evaluated based on the Progress Test?

Abstract: Introduction: Although specialized knowledge is a fundamental element for qualified medical practice, in most specialties, there is no unified cognitive assessment of resident physicians, and it is impossible to verify the knowledge gained during training in Medical Residency Programs (MRPs). The Progress Test (PT) provides an opportunity to evaluate MRPs based on the performance of the residents. In 2018, Febrasgo applied the Resident Progress Test in Gynecology and Obstetrics (TPI-GO) throughout Brazil. Experience report: This descriptive study refers to the longitudinal follow-up of residents who started participating in the TPI-GO in 2018 as R1 (n=497) and completed their participation in 2020 as R3 (n = 314). The performance of these residents in the TPI-GO served as a basis for analyzing the profile of 32 MRPs located in the South (28.1%), Southeast (68.8%), and Central-West (3.1%) regions of Brazil, with five different identified PRM profiles in relation to the performance of beginner residents, differences in performance between R3 and R1 and the performance of residency graduates. Discussion: In Brazil, comprehensive and unified assessments of knowledge are not offered to resident physicians in most specialties, and consequently, it is not yet possible to incorporate this information into the assessment of MRPs. In the model presented here, the performance of residents in the PT enables one to make inferences about the selection process, the knowledge added by the MRP throughout the training, and the level of knowledge of the graduates, being recognized as qualified MRPs (type 1) and MRPs that need improvement (types 2, 3, 4 and 5). Conclusion: The PT offers an opportunity to evaluate MRPs based on the performance of their residents. Through the model presented here, it is possible to obtain information to support institutional decisions that promote improvements in MRPs and their training process in the specialty.

摘要：引言 尽管专科知识是合格行医的核心要素，但在多数专科领域，目前尚未针对住院医师建立统一的认知评估体系，亦无法验证住院医师在住院医师培训项目（Medical Residency Programs，MRPs）期间所习得的专业知识。进展测试（Progress Test，PT）为基于住院医师表现评估住院医师培训项目提供了可行路径。2018年，Febrasgo在巴西全国范围内推行了妇产科住院医师进展测试（Resident Progress Test in Gynecology and Obstetrics，TPI-GO）。

经验报告 本描述性研究针对2018年以R1身份（第一年住院医师，样本量n=497）参与TPI-GO，并于2020年以R3身份（第三年住院医师，样本量n=314）完成测试的住院医师开展纵向随访。上述住院医师在TPI-GO中的表现，作为分析巴西32个住院医师培训项目特征的依据，这些项目分布于巴西南部（28.1%）、东南部（68.8%）与中西部（3.1%）地区；研究针对住院医师新手表现、R3与R1的表现差异以及住院医师结业者的表现，识别出五种不同的项目特征。

讨论 在巴西，多数专科领域的住院医师尚未接受全面统一的知识评估，因此目前仍无法将此类评估信息纳入住院医师培训项目的考核体系。在本研究提出的评估模型中，住院医师在进展测试中的表现可用于推断其选拔流程、住院医师培训项目在全程培训中新增的知识储备，以及结业医师的知识水平；据此可将住院医师培训项目划分为合格项目（1型）与待改进项目（2、3、4、5型）。

结论 进展测试为基于住院医师表现评估住院医师培训项目提供了可行途径。通过本研究提出的评估模型，可获取相关信息，为推动各专科住院医师培训项目及其培训流程优化的机构决策提供支撑。