Exploring Perspectives from Internal Medicine Clerkship Directors in the USA on Effective Narrative Evaluation: Results
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ORIGINAL RESEARCH
Exploring Perspectives from Internal Medicine Clerkship Directors in the USA on Effective Narrative Evaluation: Results from the CDIM National Survey Robert Ledford 1 & Alfred Burger 2 & Jeff LaRochelle 3 & Farina Klocksieben 1 & Deborah DeWaay 1 & Kevin E. O’Brien 1
# International Association of Medical Science Educators 2019
Abstract Purpose Clinical performance evaluations play a critical role in determining medical school clerkship grades. This study aimed to provide clarification from clerkship directors in internal medicine on what constitutes an effective and informative narrative description of student performance. Methods In September 2016, the Clerkship Directors in Internal Medicine (CDIM) electronically administered its annual, voluntary, and confidential cross-sectional survey of its US membership. One section of the survey asked six questions regarding the helpful components of an effective narrative evaluation. Respondents were asked to rate the effectiveness of elements contained within narrative evaluations of students. Results Ninety-five CDIM members responded to the survey with an overall response rate of 74.2%. Descriptions of skills and behaviors were felt to be the most important, followed by a description of the overall synthetic or global assessment level of the student. Descriptions of personality and attitude were the next highest rated feature followed by adjectives describing performance. Length was felt to be the least important component. In free-text comments, several respondents indicated that direct observation of performance and specific examples of skills and behaviors are also desirable. Conclusions Narrative evaluations of students that explicitly comment on skills, behaviors, and an overarching performance level of the learner are strongly preferred by clerkship directors. Direct observation of clinical performance and giving specific examples of such behaviors give evaluations even more importance. Faculty development on evaluation and assessment should include instruction on these narrative assessment characteristics. Keywords Learner assessment . Narrative evaluation . Faculty development
Introduction Clerkship directors and attending physicians are obligated to provide a narrative evaluation to their learners [1–3]. Unfortunately, prior work has shown that the quality of such written evaluations is low [3], and as many as 20% of evaluations include no narrative comments [4]. Written feedback in * Kevin E. O’Brien [email protected] 1
Department of Internal Medicine, Division of Hospital Medicine, University of South Florida Morsani College of Medicine, 12901 Bruce B. Downs Boulevard, MDC 80, Tampa, FL 33612, USA
2
Icahn School of Medicine at Mount Sinai, New York, NY, USA
3
Department of Medical Education, University of Central Florida College of Medicine, Orlando, FL, USA
the form of a narrative evaluation should be timely, specific, focused on skills, and provide meaningful feedback to improve performance [4–8]. Unfortunately, clerkship d
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