To the Editor: In the article by Shah et al. (1), the authors sought to measure the effect of an electronic reminder on the rate of return of paper-based resident performance evaluations by faculty. The electronic reminder increased the rate of completion from 48% to 80%. In follow-up, we designed a study to determine whether providing evaluations in an electronic format increases the rate of return of evaluations by attending psychiatrists.

At our training program, attending physicians receive an e-mail notification of a website that allows them to complete resident evaluation forms that are identical to the paper version used previously. Such notice is sent 5 days before the end of the resident inpatient rotation with the attending physician. To complete the evaluation, the attending physician clicks the link to a website and completes the evaluation after signing in with the same user name and password they use for their official e-mail. The evaluation takes approximately 10 minutes. An electronic reminder is sent every 10 days to the attending physicians who have not completed the evaluations.

After an Institution Review Board approval, we retrospectively assessed the rate and timing of receipt of resident evaluations completed by the attending psychiatrists during the academic year 2009–2010 (July to June, inclusive). All the information was anonymously collected.

All of the evaluations (100%) were completed and received back by the training office. Only 23 of the 44 evaluations (or slightly over half the evaluations) were completed within 1 month of the end of the rotation. An additional 10 evaluations were received during the following month. Thus, 75% of the evolutions were received in the first 2 months. The remaining 25% were received by 140 days after the rotation.

Rate of completion of the paper version of the psychiatry resident evaluations in our previous study increased from 48% to 80% after using e-mail reminders (1). Implementing the electronic version of the evaluation increased the rate of return to 100%. However, only half of the evaluations were returned in 1 month. One-quarter of the evaluations were still missing after 2 months. Since timeliness of the evaluations is of the essence to ensure proper remedial steps, there remains some room for improvement in the timeliness of response. Limitations of this study include small sample size, and short study duration. Replication of the results in other institutions would ensure that these results can be generalized.

It thus appears that the electronic evaluation forms, coupled with e-mail reminders every 10 days, satisfactorily ensure that all the evaluations are eventually completed. Methods to improve the timeliness of evaluation completion need to be studied. For example, establishing rules that link assigning residents to future rotations with attending physicians who complete their rotation evaluations promptly may serve as a positive reinforcement for the desirable behavior. Allowing attending physicians in good standing a choice of the resident who will work with them offers an alternate method of inducement.