Department of Surgery, University of Washington, Seattle, Washington.
Irvine School of Medicine, University of California, Orange, California.
J Surg Educ. 2022 Jan-Feb;79(1):157-164. doi: 10.1016/j.jsurg.2021.08.022. Epub 2021 Sep 12.
Medical Student Performance Evaluation (MSPE) letters provide critical comparative information about clerkship performance, and are a crucial part of the surgical residency application. The elimination of USMLE Step 1 numeric reporting increases the importance of transparency, standardization, and accessibility of comparative information reported on the MSPE. The objective of our study was to measure the variability in clerkship grade reporting on the MSPE from US medical schools, particularly focusing on the highest (honors) grades.
DESIGN, SETTING, AND PARTICIPANTS: We identified representative MSPE letters from US medical schools and recorded the percentage of honors for 5 core clerkships. We grouped medical schools according to medical school rankings, geographic region, and number of grading categories RESULTS: Of 122 medical schools, 106 schools (87%) reported their grading scheme and percent honors. The most commonly used grading scheme was a 4-tier system (51/122; 42%). The percentage of honors was highly variable (from 1-91%) and did not vary by region. However, schools in the top 20 research ranking were less likely to report grade comparisons (30% vs. 10%), and more likely to award more students honors in 4 of the 5 clerkships. Schools in the top 20 primary care ranking were more likely to award more honors in the medicine clerkship.
There is significant variability in the number of grading tiers used and the percentage of students awarded honors across US medical schools. Factors that correlated to higher grades included schools with higher rankings, and higher ranked schools were less likely to report comparative information at all.
学生表现评估（MSPE）信提供了关于实习表现的关键比较信息，是外科住院医师申请的重要组成部分。USMLE 步骤 1 数字报告的消除增加了 MSPE 上报告的比较信息的透明度、标准化和可访问性的重要性。我们研究的目的是衡量美国医学院的 MSPE 成绩报告的变异性，特别是重点关注最高（荣誉）成绩。
设计、环境和参与者：我们从美国医学院确定了有代表性的 MSPE 信，并记录了 5 个核心实习的荣誉成绩百分比。我们根据医学院排名、地理位置和评分类别将医学院分组。
在 122 所医学院中，有 106 所（87%）报告了他们的评分方案和荣誉成绩百分比。最常用的评分方案是 4 级系统（51/122；42%）。荣誉成绩百分比差异很大（从 1%到 91%），与地理位置无关。然而，排名前 20 的研究型学校更不可能报告成绩比较（30%对 10%），而且在 5 个实习中，有 4 个更有可能授予更多学生荣誉成绩。排名前 20 的初级保健排名的学校更有可能在医学实习中授予更多的荣誉成绩。
美国医学院使用的评分层次数量和授予荣誉成绩的学生百分比存在显著差异。与更高成绩相关的因素包括排名较高的学校，而排名较高的学校更不可能报告所有比较信息。
