Abstract
Background
Clerkship directors routinely evaluate medical students using multiple modalities,
including faculty assessment of clinical performance and written examinations. Both
forms of evaluation often play a prominent role in final clerkship grade. The degree
to which these modalities correlate in an emergency medicine (EM) clerkship is unclear.
Objective
We sought to correlate faculty clinical evaluations with medical student performance
on a written, standardized EM examination of medical knowledge.
Methods
This is a retrospective study of fourth-year medical students in a 4-week EM elective
at one academic medical center. EM faculty performed end of shift evaluations of students
via a blinded online system using a 5-point Likert scale for 8 domains: data acquisition,
data interpretation, medical knowledge base, professionalism, patient care and communication,
initiative/reliability/dependability, procedural skills, and overall evaluation. All
students completed the National EM M4 Examination in EM. Means, medians, and standard
deviations for end of shift evaluation scores were calculated, and correlations with
examination scores were assessed using a Spearman's rank correlation coefficient.
Results
Thirty-nine medical students with 224 discrete faculty evaluations were included.
The median number of evaluations completed per student was 6. The mean score (±SD)
on the examination was 78.6% ± 6.1%. The examination score correlated poorly with
faculty evaluations across all 8 domains (ρ 0.074–0.316).
Conclusion
Faculty evaluations of medical students across multiple domains of competency correlate
poorly with written examination performance during an EM clerkship. Educators need
to consider the limitations of examination score in assessing students' ability to
provide quality patient clinical care.
Keywords
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References
- State of undergraduate education in emergency medicine: a national survey of clerkship directors.Acad Emerg Med. 2014; 21: 92-95
- Report of the task force on national fourth year medical student emergency medicine curriculum guide.Ann Emerg Med. 2006; 47: E1-E7
- Emergency medicine clerkship curriculum: an update and revision.Acad Emerg Med. 2010; 17: 638-643
- The ACGME outcome project: retrospective and prospective.Med Teach. 2007; 29: 648-654
- A survey of student assessment in U.S. medical schools: the balance of breadth versus fidelity.Teach Learn Med. 2001; 13: 74-79
- Creation and implementation of a national emergency medicine fourth-year student examination.J Emerg Med. 2013; 45: 924-934
- Correlation of the NBME advanced clinical examination in EM and the EM M4 exams.West J Emerg Med. 2015; 16: 138-142
- Faculty and resident evaluations of medical students on a surgery clerkship correlate poorly with standardized exam scores.Am J Surg. 2014; 207: 231-235
- Knowledge base evaluation of medicine residents on the gastroenterology service: implications for competency assessments by faculty.Clin Gastroenterol Hepatol. 2003; 1: 64-68
- Assessment of resident knowledge: subjective assessment versus performance on the ACR in-training examination.Acad Radiol. 1999; 6: 66-71
- Faculty prediction of in-training examination scores of emergency medicine residents.J Emerg Med. 2014; 46: 390-395
- Validity of faculty and resident global assessment of medical students' clinical knowledge during their pediatrics clerkship.Acad Pediatr. 2012; 12: 138-141
- Low correlation between subjective and objective measures of knowledge on surgery clerkships.J Am Coll Surg. 2010; 210: 680-683
- Shortcomings in the evaluation of students' clinical skills and behaviors in medical school.Acad Med. 1999; 74: 842-849
The Accreditation Council for Graduate Medical Education website. Emergency medicine core competencies. Available at: http://www.acgme.org/acgmeweb/Portals/0/PDFs/FAQ/110_emergency_medicine_FAQs_07012013.pdf. Accessed July 12, 2015.
- The development of the emergency medicine milestones.Acad Emerg Med. 2013; 20: 724-729
Association of American Medical Colleges Drafting Panel website. Core entrustable physician activities for entering residency (updated). Available at: https://www.mededportal.org/icollaborative/resource/887. Accessed July 12, 2015.
- Medical student milestones in emergency medicine.Acad Emerg Med. 2014; 21: 905-911
- The effects of violating standard item writing priciples on tests and students: the consequences of using flawed test items on achievement examinations in medical education.Adv Health Sci Educ Theory Pract. 2005; 10: 133-143
- Anatomy of a clerkship test.Acad Emerg Med. 2010; 17: S31-S37
Article info
Publication history
Published online: March 21, 2017
Accepted:
September 12,
2016
Received:
September 6,
2016
Footnotes
Reprints are not available from the authors.
Identification
Copyright
© 2016 Elsevier Inc. All rights reserved.
