To the Editor: 

The investigation in education by Baker1is an excellent source of information for practicing academic anesthesiologists involved in resident education. Despite efforts to normalize evaluations and potentially control for bias, concerns remain about the structure of this or any evaluation system because of unavoidable introduction of faculty bias. Baker's results show that none of the residents received a score less than 3 and evaluations consistently increased with progression through CA-1 to CA-3 yr. Although acknowledging the finding, does Baker have any explanation for this, or whether this may be related to the faculty cohort here or for all faculty? In addition to unintentional penalty for being less experienced as a CA-1, the more senior the resident, the longer the time that a particular faculty has spent with a resident. A longer professional relationship will likely lead to greater confidence in assigning a higher evaluation grade, especially if residents with lower scores have been removed from the peer group by attrition.

Of greater significance, is the faculty really free not to be biased? When faculty are aware that their resident evaluations are accessible to the resident, acknowledging that their own teaching evaluations may subsequently be affected in a retaliatory fashion, a positive bias is expected.

As doubts remain whether faculty are assigning unbiased scores of resident evaluations, more information is required from academic educators, including how well residents and faculty are matched in terms of time and cases done together to allow accurate assessment of performance.

Baker K: Determining resident clinical performance: Getting beyond the noise. ANESTHESIOLOGY 2011; 115:862–78