医学生绩效评估的现状：透明度提高还是持续模糊？
The State of Medical Student Performance Evaluations: Improved Transparency or Continued Obfuscation?
作者信息
Hom Jason, Richman Ilana, Hall Philip, Ahuja Neera, Harman Stephanie, Harrington Robert, Witteles Ronald
机构信息
J. Hom is clinical instructor, Department of Medicine, Stanford University School of Medicine, Stanford, California. I. Richman is a health services research fellow, Center for Health Policy/Primary Care and Outcomes Research, Stanford University, Stanford, California. P. Hall is a fellow in cardiovascular medicine, University of California, San Francisco, San Francisco, California. N. Ahuja is clinical associate professor, Department of Medicine, Stanford University School of Medicine, Stanford, California. S. Harman is clinical assistant professor, Department of Medicine, Stanford University School of Medicine, Stanford, California. R. Harrington is Arthur Bloomfield Professor of Medicine and chair, Department of Medicine, Stanford University School of Medicine, Stanford, California. R. Witteles is associate professor, Department of Medicine, and program director, Internal Medicine Residency Training Program, Stanford University School of Medicine, Stanford, California.
出版信息
Acad Med. 2016 Nov;91(11):1534-1539. doi: 10.1097/ACM.0000000000001034.
PURPOSE
The medical student performance evaluation (MSPE), a letter summarizing academic performance, is included in each medical student's residency application. The extent to which medical schools follow Association of American Medical Colleges (AAMC) recommendations for comparative and transparent data is not known. This study's purpose was to describe the content, interpretability, and transparency of MSPEs.
METHOD
This cross-sectional study examined one randomly selected MSPE from every Liaison Committee on Medical Education-accredited U.S. medical school from which at least one student applied to the Stanford University internal medical residency program during the 2013-2014 application cycle. The authors described the number, distribution, and range of key words and clerkship grades used in the MSPEs and the proportions of schools with missing or incomplete data.
RESULTS
The sample included MSPEs from 117 (89%) of 131 medical schools. Sixty schools (51%) provided complete information about clerkship grade and key word distributions. Ninety-six (82%) provided comparative data for clerkship grades, and 71 (61%) provided complete key word data. Key words describing overall performance were extremely heterogeneous, with a total of 72 used and great variation in the assignment of the top designation (median: 24% of students; range: 1%-60%). There was also great variation in the proportion of students awarded the top internal medicine clerkship grade (median: 29%; range: 2%-90%).
CONCLUSIONS
The MSPE is a critical component of residency applications, yet data contained within MSPEs are incomplete and variable. Approximately half of U.S. medical schools do not follow AAMC guidelines for MSPEs.
目的
医学生表现评估（MSPE）是一份总结学术表现的信函，包含在每位医学生的住院医师申请材料中。医学院校遵循美国医学院协会（AAMC）关于提供可比且透明数据建议的程度尚不清楚。本研究旨在描述MSPE的内容、可解释性和透明度。
方法
这项横断面研究从2013 - 2014年申请周期内向斯坦福大学内科住院医师项目至少提交一份申请的美国医学教育联络委员会认证的每所医学院中随机抽取一份MSPE进行检查。作者描述了MSPE中使用的关键词数量、分布、范围以及临床实习成绩，以及数据缺失或不完整的学校比例。
结果
样本包括131所医学院中117所（89%）的MSPE。60所学校（51%）提供了关于临床实习成绩和关键词分布的完整信息。96所（82%）提供了临床实习成绩的比较数据，71所（61%）提供了完整的关键词数据。描述总体表现的关键词极其多样，总共使用了72个，且顶级评定的分配差异很大（中位数：24%的学生；范围：1% - 60%）。获得内科临床实习顶级成绩的学生比例也有很大差异（中位数：29%；范围：2% - 90%）。
结论
MSPE是住院医师申请的关键组成部分，但MSPE中的数据不完整且存在变数。约一半的美国医学院校未遵循AAMC关于MSPE的指南。
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