Publication Date
9-1-2024
Journal
Family Medicine
DOI
10.22454/FamMed.2024.819598
PMID
38935851
PMCID
PMC11412289
PubMedCentral® Posted Date
6-13-2024
PubMedCentral® Full Text Version
Post-Print
Published Open-Access
yes
Keywords
Humans, Clinical Clerkship, Family Practice, Educational Measurement, Clinical Competence, Surveys and Questionnaires, Internship and Residency, Faculty, Medical, Students, Medical, Preceptorship, assessment, grading, undergraduate medical education
Abstract
BACKGROUND AND OBJECTIVES: As application to residency programs becomes increasingly competitive, educational leaders face growing student concern about imprecise clinical assessments and clerkship grades.
METHODS: As part of a large annual survey of family medicine clerkship directors (FMCDs), 10 questions were disseminated in May 2023 about perceived levels of imprecise assessments by faculty. We aimed to determine to what extent respondents felt their institution's evaluation system propagated inaccurate grading.
RESULTS: A total of 52% of 169 FMCDs responded to the survey. Of these, 7% of respondents were completely confident that their preceptors would give two students of identical competence the same clinical evaluation rating. FMCDs estimated that an average of 38% of their preceptors inaccurately rate student performance. Most clerkships use an Honors/High Pass/Pass/Fail grading system. We found that 51% of FMCDs prefer to use a different grading paradigm than they currently use. We asked FMCDs to estimate the percentage of students that expressed concern over inaccurate preceptor ratings. Grading systems with more tiers were associated with a higher percentage of concerned students.
CONCLUSIONS: Clerkship grades are widely used by residency program directors to classify and differentiate student applicants. We identified a significant concern from FMCDs that clinical evaluation ratings can vary greatly. Given the high stakes and perceived inaccuracy of clerkship grading, we recommend continued investigation into the appropriate weighing and usage of clinical evaluations. Continued exploration is recommended to develop grading paradigms centered on criterion-based assessment.
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