Objectives: 1) To determine whether nurse evaluations of humanistic behavior discriminate between houseofficers in an internal medicine training program, and 2) to compare nurse and attending physician evaluations.
Design: Prospective, six-month comparison of nurse and attending ratings of houseofficer humanistic behavior.
Procedure: Using a six-item, Likert-scale humanistic behavior rating form, nurses and ward attendings evaluated 76 PGY-1, PGY-2, and PGY-3 houseofficers over a six-month period. Nurses and attendings voluntarily evaluated houseofficers on all inpatient units in both university and Veterans Administration teaching hospitals.
Measurements and main results: Nurse ratings discriminated residents from one another throughout the six months of the study and over all units in both hospitals. Attending physician ratings were only moderately correlated with nurses' and were significantly more lenient. Exploratory analyses of the nursing evaluations revealed that female houseofficers received significantly more favorable evaluations than did men and that ward nurses were significantly more lenient than were critical care nurses. Nurse ratings did not differ by hospital, training year, or month of evaluation.
Conclusions: Nurses can provide information about humanistic behavior that will allow program directors to discriminate among different levels of houseofficer behavior. Information from nurses differs from that provided by attending physicians. Nurse ratings are affected by gender and by the type of unit from which they are obtained.