Patient Assessment and Management Examination: lack of correlation between faculty assessment and resident self-assessment

Background: The Patient Assessment and Management Examination (PAME) is a standardized patient examination designed to assess management skills of senior residents. This study explored the relationship between faculty and resident self-evaluation by using PAME. Methods: Nine postgraduate year (PGY) 4 and PGY5 residents were examined with a 5 case PAME. Faculty rated interactions between residents and standardized patients and residents rated themselves based on review of audio-video recordings of their interactions. We examined correlations between faculty and resident self-assessments. Results: Faculty and resident ratings of physical examination skills was the only competency that correlated significantly. Correlations were not significant for the other 15 competencies (Pearson r, -.197 to .262). Correlation was no better when examined within each case. Conclusions: Although PAME may be a useful tool, this study suggests that even senior residents do not assess their performance as clinicians similarly to faculty. Further research is needed to better understand the source of these disagreements.