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Improving the Grading Process by Applying A Shared Mental Model

Regular Formal Evaluation Sessions are Effective as Frame-of-Reference Training for Faculty Evaluators of Clerkship Medical Students. Hemmer P et al. JGIM 2015; PMID: 26173519

Reviewed by Jeanine Ronan

What was the study question?
Does attendance at formal evaluation sessions facilitated by clerkship directors improve the ability of attending physicians to apply the shared mental model of the RIME schematic to student evaluations?

How was the study done?
At a single multisite medical school (Uniformed Services University) that uses the RIME framework to determine clerkship grades in internal medicine, some clerkship faculty attend structured evaluation sessions held regularly during the clerkship to discuss student performance, while other faculty do not. In this retrospective cohort study, narrative evaluations by faculty were coded looking for implicit and explicit utterances of the RIME framework. The frequency of these utterances as well as the correlation between faculty-recommended grades and students’ overall clinical grades was compared between faculty who attended the sessions and those who did not.

What were the results?
293 teacher narratives were coded. 98% of session attendee narratives included implicit or explicit RIME utterances compared to 74.5% of non-attendees. Grades recommended by attendees correlated strongly with the students’ overall grades whereas non-attendees grades correlated only moderately.

What are the implications of these findings?
This study illustrates the importance of developing a shared mental model for student evaluations through faculty attendance at formal evaluation sessions. The consistency and reliability of evaluations can be improved through this simple faculty development intervention. The authors did not study whether the number of sessions attended correlated with faculty adoption of the RIME framework.

Editor’s Note: The authors correctly point out that the RIME framework is well-known at their institution and also relatively easy to use. It would be interesting to see how formal evaluation sessions impact the use of other frameworks such as ACGME milestones (JG).

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