The Subjectivity in Evaluation of Resident Physicians in Medical Clinic Programs

Abstract. This study focuses on the resident physicians’ evaluation in medical residency programs. In Brazil, such programs must periodically evaluate the resident, at least every quarter, either by oral or written test, practice, or scale of attitudes and have a monograph to complete the course. In this research, the central guiding question was: how is the evaluation of the resident physician in two residency programs in medical clinic? Thus, the objective of the study was to understand the evaluation process of resident physicians in medical clinic programs under different points of view. The study adopts a qualitative approach, with an exploratory and descriptive model, developed in Cascavel, Parana, Brazil, in two health institutions, one public and the other one private, both of them teaching hospitals. The research participants were the coordinators of the two training programs, the preceptors, totaling eight and the residents, totaling 21 individuals. For the data collection with the coordinators a semi-structured interview was carried out, considering a script adaptation from Botti (2009) and Castells (2014) and four focal groups with the other participants. The data were collected among October, 2016 and March, 2017. Considering the readings, reflections and analysis, the data were grouped in two units. Themes were produced by the convergences and/or divergences in the testimonies and based on the sense cores emerged from the data. Thus, the results were presented in two thematic units: the resident physicians evaluation from different points of view among the subjects and subjectivity in the evaluation of values, attitudes and behaviors. Just the last one is presented in this abstract. Regarding the subjectivity of the evaluation as the acquisition of knowledge, values, attitudes, behaviors, interpersonal relationship and/with patients, assiduity, quality in medical actions, are evidenced in this study. Contrarily, Venturelli (2015, p. 45) focuses on the role of the mentor/supervisor/preceptor, the necessity to "lead the student to face a set of important concepts, ideas and techniques that emerge significant contradictions and concerns to unfold their creativity, flexibility, and metacognitive reflection". Regarding the skills acquisition supported by preceptors, both residents and preceptors reported the difficulty of evaluation, because the residents do not perceive what they are being evaluated and the preceptors mention to apply a daily evaluation, without specifying what it consists of. On the contrary, in the study of Sant'Ana & Pereira (2016), about the preceptor supervision, they found this element to be fundamental to the teaching-learning process, since being a preceptor means transmitting knowledge and being responsible for vocational training. The reality about the evaluation in residency programs in medical clinics was worrisome. The medical evaluation during the training process in the residency programs studied is performed only after a training period, the summative process, which selects the resident to the next stage, as determined by the regulations. Moreover, subjective assessment is not clear, mainly due to the lack of evaluation tools known and adopted by all subjects.