In the current issue of the journal, Tam and colleagues explore the use of previously undocumented data, or PUD, about resident performance in making assessment decisions at the level of the clinical competency committee (CCC) at a relatively small postgraduate subspecialty program [1]. Tam and colleagues define previously undocumented data as any information contributing to CCC discussions that was not in documentation brought to the meeting. They provide four categories of this data: summary impressions, contextualizing factors, personal anecdotes and hearsay. While others have described use of such data in CCCs, [2, 3] Tam et al. elaborate on reasons for using this data during CCC meetings and methods for managing it during discussions. The authors suggest that given current limitations of most programs of assessment, there are likely benefits of using previously undocumented data in CCCs to make decisions, and they advocate for this as an acceptable practice. They argue that this practice can help fill gaps in assessment data that are often lacking in quantity, quality or clarity [1]. We agree whole-heartedly that suboptimal assessment data is a major barrier to CCCs making optimal and defensible decisions [4, 5] and that a better understanding of previously undocumented data can help CCCs manage it during meetings. However, Tam and colleagues also acknowledge the potential limitations of their findings. Building on this, we believe four issues warrant further exploration: 1) use of previously undocumented data as a symptom of suboptimal programmatic assessment that perhaps should not be used to justify its routine use, 2) the role of program size in the study’s findings, 3) the potential introduction of bias created when using previously undocumented data, and 4) the likely range of trainee acceptance regarding previously undocumented data use.
展开▼
