Lucy Y. Chang,NYU School of Medicine,New York,NY,Linda R. Tewksbury,NYU School of Medicine,New York,NY,Harris Burstin,NYU School of Medicine,New York,NY,Sandra Yingling,NYU School of Medicine,New York,NY,Martin V. Pusic,NYU School of Medicine,New York,NY,Sabrina Lee,NYU School of Medicine,New York,NY,Rhonda G. Acholonu,NYU School of Medicine,New York,NY
Background: The LCME requires that all students receive formative mid-clerkship feedback on their clinical skills. This provides an ideal forum for students to assess their own skills and compare that to faculty feedback. Little is known about how student self-assessment compare to pediatric faculty assessment at this junction of training.
Objective: To determine: 1) feasibility of using a portable tablet application to collect student and faculty preceptor assessments of student clinical skills at pediatric clerkship mid-point, 2) extent of agreement between student and preceptor assessments.
Methods: Using a custom-designed iPad application (PRIMES), students answered six self-assessment questions mid-clerkship on Professionalism, Reporting, Interpreting, Managing, Educating and Procedural Skills; each rated on a 4-point scale (Not Yet Begun, Beginning, Competent, Strong) with behavioral anchors. Preceptors, blinded to student assessment, then completed the same app during a face-to-face meeting, based on clinical feedback and weekly small group meetings with students. The app displays a comparison of the two sets of ratings, facilitating discussion of student’s individualized learning plan.
Results: 73/86 (85%) of student-preceptor pairs completed PRIMES ratings over four clerkship rotations. On average, ratings were in agreement 60% of the time (Professionalism 67%, Reporting 68%, Interpreting 68%, Managing 52%, Educating 56%). Of the 24 pairs that disagreed on Professionalism, most had student self-ratings that were higher than preceptor ratings (83%). In comparison, of the 23 pairs that disagreed on Interpreting, most had student self-ratings that were lower than preceptor ratings (70%).
Discussion: Our pilot demonstrates the feasibility of using the PRIMES app to incorporate student self-assessment into formative mid-clerksip feedback sessions in the pediatric clerkship. Students and preceptors were more likely to agree on assessment of Professionalism, Reporting and Interpreting skills compared to the more advanced skills of Managing and Educating. Disagreement occurred in both directions, with students more likely to rate their abilities higher in professionalism and lower in interpreting compared to their preceptors. Further research is needed to determine if student preceptor disagreement can lead to more meaningful feedback to help students improve their clinical skills through reflective practice.