Nurses and Faculty Evaluating Internal Medicine Housestaff

Background: Residency programs are responsible for adequately assessing the skills of housestaff. Purpose: To determine the feasibility and reliability of nurses evaluating clinical competence of Internal Medicine (IM) housestaff. Methods: IM housestaff were evaluated by nurses, faculty, and the program director. Composite scores were calculated for skills classified as clinical/technical or interpersonal. Generalizability analysis was used to determine the number of items required and the nmber of evaluation forms to be completed to achieve acceptable reliability. Results: IM housestaff were rated highly by all types of evaluators. Ratings by nurses and faculty were global. There was a low correlation between ratings by nurses and faculty of clinical/technical skills. To achieve an acceptable reliability (r = .80) on clinical/technical skills 5 to 10 faculty were needed to complete 1 to 2 questions, whereas 20 to 30 nurses were required to complete 1 to 2 questions to assess clinical/technical or interpersonal skills. Conclusion: Nurses are willing to evaluate IM housestaff and an acceptable reliability can be achieved with a reasonable number of nurses.