ArticleFrontiers in medicine2026
Design, implementation, and evaluation of a programmatic assessment model in an emergency medicine residency: a mixed-methods study.
Article in Frontiers in medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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9 authors.
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Abstract
Background: Programmatic assessment (PA) is widely endorsed in postgraduate medical education, but empirical accounts of real-world implementation in emergency medicine (EM) remain limited and are concentrated in North American settings. We piloted and evaluated the design, implementation, and outcomes of a PA model in an EM residency at a high-volume tertiary care center in Türkiye. Methods: A mixed-methods study was conducted over an eight-month pilot (November 2024-June 2025). Program design and evaluation followed a Theory of Change framework applied across three sequential phases: a structured gap analysis informed by external medical-education experts, competency-based blueprint development across six domains, and pilot implementation in a small core-faculty and resident cohort. Outcomes included feasibility (assessment volume and participation), cohort-level educational impact (longitudinal performance via paired-sample comparisons), and acceptability (as measured by an end-of-pilot satisfaction survey and qualitative feedback). Results: A total of 3,107 assessment data points were documented across all six competency domains. Among 16 residents with paired baseline and follow-up data, cohort-level relative performance increased significantly in five of six domains. Evidence-Based Medicine and Lifelong Learning did not change significantly. The survey response rate was 89.5%, and 82.4% of respondents endorsed continuing the program. Acceptability data converged across streams: residents simultaneously valued the multisource perspective and voiced concerns about feedback culture, with the burden of form completion as the dominant practical concern. Conclusions: Implementation was feasible, accompanied by positive change in cohort-level relative performance, and was broadly acceptable. The most informative finding was a tension between the system's formative design intent and how some residents experienced it, which directly informs next-cycle priorities focused on feedback culture, technology integration, and sustainability.
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