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Attitudes of Affiliate Faculty Members Toward Medical Student Summative Evaluation for Clinical Clerkships: A Qualitative Analysis. Wang KE, Fitzpatrick C, George D, Lane L. Teaching and Learning in Medicine 2012;24(1):8-17.

Reviewed by Jonathon Gold

What was the study question? As the title suggests, what are the attitudes that affiliate faculty have toward summative evaluation of medical students?

How was the study done? Semistructured interviews, focus groups, and brief surveys were performed. The participants were educators across multiple disciplines at a single clinical site affiliated with several medical schools. Themes were identified using qualitative methods.

What are the results? Investigators identified three themes: factors that influence grading, consequences of negative evaluations, and disconnections in the grading process. Factors that influenced grading included items such as the need for sufficient time with the student to perform adequate evaluations, inconsistent or vague criteria for grading, and the importance of professional (or unprofessional) behaviors in determining grades. Consequences of negative evaluations included fear of derailing the student's career, fear of damaging relationships with the medical school, and fear of discouraging potential residency applications through harsh grading. Disconnections in the grading process included lack of training or understanding of the various grading forms used by medical schools and lack of knowledge about previous patterns of student behavior or ability to feed concerns about students forward to the medical school.

What are the implications of these findings? Many of the themes identified in this study are similar to those found in other analysis of summative evaluations—difficulties related to lack of sufficient time observing a student, lack of clear measurable criteria, fear of reprisal and grading of nonperformance attributes. However, the theme of disconnectedness may be more unique to faculty at sites more distant from the primary medical school. The authors correctly point out the need for not only faculty development regarding the use of these evaluations but also the need for strong relationships and lines of communication between the onsite evaluator and the responsible medical school.
Although this study was performed at a single site only and should be repeated in more settings, to me the issues raised have certain face validity. As a clerkship director at a community-based medical school with multiple campuses, use of summative evaluations have always created some difficulties for students at our various sites, with many students and faculty suspecting that faculty at each site are using the evaluation forms somewhat differently. Attempts to improve the process have involved several revisions of our evaluation forms and regular faculty development in various formats, but it remains an ongoing challenge.

Editor's note: This article is hot off the press (February 2012!) and is from one of COMSEP's own - Lindsay Lane!! (SLB)

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