The Ottawa Resident Observation Form for Nurses (O-RON): Assessment of Resident Performance through the Eyes of the Nurses

OBJECTIVE: Most work-place based assessment relies on physician supervisors making observations of residents. Many areas of performance are not directly observed by physicians but rather by other healthcare professionals, most often nurses. Assessment of resident performance by nurses is captured with multi-source feedback tools. However, these tools combine the assessments of nurses with other healthcare professionals and so their perspective can be lost. A novel tool was developed and implemented to assess resident performance on a hospital ward from the perspective of the nurses. DESIGN: Through a nominal group technique, nurses identified dimensions of performance that are reflective of high-quality physician performance on a hospital ward. These were included as items in the Ottawa Resident Observation Form for Nurses (O-RON). The O-RON was voluntarily completed during an 11-month period. Validity evidence related to quantitative and qualitative data was collected. SETTING: The Orthopedic Surgery Residency Program at the University of Ottawa. PARTICIPANTS: 49 nurses on the Orthopedic Surgery wards at The Ottawa Hospital (tertiary care). RESULTS: The O-RON has 15 items rated on a 3-point frequency scale, one global judgment yes/no question regarding whether they would want the resident on their team and a space for comments. 1079 O-RONs were completed on 38 residents. There was an association between the response to the global judgment question and the frequency of concerns (p < 0.01). With 8 forms per resident, the reliability of the O-RON was 0.80. Open-ended responses referred to aspects of interpersonal skills, responsiveness, dependability, communication skills, and knowledge. CONCLUSIONS: The O-RON demonstrates promise as a work-place based assessment tool to provide residents and training programs with feedback on aspects of their performance on a hospital ward through the eyes of the nurses. It appears to be easy to use, has solid evidence for validity and can provide reliable data with a small number of completed forms. (C) 2021 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Automated summary

A novel tool was developed to assess resident performance on a hospital ward from the perspective of nurses, showing promise as a workplace-based assessment tool. Nurses identified dimensions of high-quality physician performance on a hospital ward, with reliability of the tool being high. Nurses emphasized the importance of interpersonal skills, responsiveness, dependability, communication skills, and knowledge in physician performance on the ward.