ABSTRACT
Effective residents differ little from specialty to specialty; all display efficient integration of the cognitive, affective, and motor domains. Written input should be obtained after each rotation from sources less threatening to the resident, including peers, nurses, patients, and perhaps the house officers themselves – a "360 degree" evaluation. Standardized techniques for evaluation of competence in psychomotor and interpersonal skills lag far behind. It may be necessary to use the competencies to direct and coordinate more specific evaluations rather than attempting direct measurement of the individual competencies. Both reliability and validity are critical for assessment of item mastery; however, with the curricular expansion resulting from the addition of core competencies, professional judgment has become an important element in evaluation. Competence in a given area can be based on testing, consensus of expert judgments, and task analyses. Performance relies more on affective or attitudinal qualities – commitment, empathy, and integrity – than competence.
