Hauer Karen E, Nishimura Holly, Dubon Diego, Teherani Arianne, Boscardin Christy
University of California at San Francisco, San Francisco, California, USA.
University of California at Berkeley, Berkeley, California, USA.
Clin Teach. 2018 Dec;15(6):472-477. doi: 10.1111/tct.12726. Epub 2017 Oct 18.
In-training evaluation reports are a commonly used assessment method for clinical learners that can characterise the development of competence in essential domains of practice. Strategies to increase the usefulness and specificity of written narrative comments about learner performance in these reports are needed to guide their learning. Soliciting narrative comments by competency domain from supervising doctors on in-training evaluation reports could improve the quality of written feedback to students.
This is a pre-post study examining narrative comments derived from assessments of core clerkship students by faculty members and resident supervisors in seven clerkships using two assessment forms in academic years 2013/14 (pre; two comments fields - summative, constructive) and 2014/15 (post; seven comments fields - six competency domains, constructive comments). Using a purposive sample of 60 students based on overall clerkship performance, we conducted content analysis of written comments to compare comment quality based on word count, competencies addressed and reinforcing or constructive content. Differences between the two forms across these three components of quality were compared using Student's t-tests.
The revised form elicited more narrative comments in all seven clerkships, with more competencies addressed. The revised form led to a decrease in the proportion of constructive comments about the students' performances. In-training evaluation reports are a commonly used assessment method for clinical learners DISCUSSION: Structural changes to a medical student assessment form to elicit narrative comments by competency improved some measures of the quality of narrative comments provided by faculty members and residents. Additional study is needed to determine how learners use this information to improve their clinical practice.
培训期间评估报告是临床学习者常用的评估方法，可描述实践关键领域能力的发展情况。需要采取策略来提高这些报告中关于学习者表现的书面叙述性评论的实用性和针对性，以指导他们的学习。在培训期间评估报告中按能力领域征求指导医生的叙述性评论，可能会提高给学生的书面反馈质量。
这是一项前后对照研究，考察2013/14学年（前；两个评论字段——总结性、建设性）和2014/15学年（后；七个评论字段——六个能力领域、建设性评论）在七个临床实习中使用两种评估表对核心临床实习学生进行评估得出的叙述性评论。基于临床实习的总体表现，我们选取了60名学生作为目的抽样，对书面评论进行内容分析，以根据字数、涉及的能力以及强化或建设性内容来比较评论质量。使用学生t检验比较这两种表格在质量的这三个组成部分上的差异。
修订后的表格在所有七个临床实习中都引发了更多的叙述性评论，涉及更多的能力领域。修订后的表格导致关于学生表现的建设性评论比例下降。培训期间评估报告是临床学习者常用的评估方法 讨论：对医学生评估表进行结构调整以按能力领域引出叙述性评论，改善了教师和住院医生提供的叙述性评论质量的一些衡量指标。需要进一步研究以确定学习者如何利用这些信息来改进他们的临床实践。
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