Validity and Reliability of Faculty Evaluations:

In Response: Dr. Balestrieri1 raises an important point relating to one use of resident-generated evaluations of their faculty. He deplores their use in the relatively high-stakes assessment of faculty performance by institutional leadership. This sentiment is informally shared by many faculty and teachers. More formal validation is needed such as was provided recently for quality of faculty supervision by de Oliveira Filho et al.2 It would be extremely helpful if groups in the United States emulate and complement these authors in this endeavor. The authors evaluated attending quality along the supervisory dimensions of anesthesia care planning, availability, feedback, professionalism, interpersonal skills, safety concern, resident autonomy, and patient based learning. There is certainly ample opportunity to study the validity of additional characteristics of successful resident-attending interactions, such as critical thinking, prioritization, decision making, evidence-based teaching/learning, and other dimensions being evaluated by thousands of residents each year. Another aspect to be assessed is whether a deliberate interven-tion in behavior or teaching style is actually capable of meaningfully changing resident evaluation scores. Furthermore, beyond addressing internal consistency and reliability, investigators should strive for external validation of teaching effectiveness assessments, perhaps through faculty observation of operating room trainee-faculty interaction by a qualified third party or by surveillance of trainee behavior in response to faculty teaching. As more becomes known about the validity of resident assessments of their faculty, use of these data should improve, with greater benefits for trainees, educators, and patients. Armin Schubert, MD, MBA Department of General Anesthesiology Cleveland Clinic Cleveland, Ohio [email protected]