Carline J D, Cook C E, Lennard E S, Siever M, Coluccio G M, Norman N L
Surgery. 1986 Jul;100(1):89-94.
Data were collected for 163 students completing a surgical clerkship including scores on patient write-ups, ward performance evaluations, oral examinations, and National Board of Medical Examiners (NBME) Surgery subscores. Oral examination scores and patient write-ups were rated from 74 (failing) to 100 (honors) by faculty members. The ward performance evaluation included ratings on nine components of ward performance from 1 (unsatisfactory) to 4 (superior) and an overall ward score of 74 (failing) to 100 (honors). Similarities and discrepancies in the way that evaluators viewed clerks were found. Weights given to ward component ratings in relationship to the overall ward score were equivalent for faculty members and residents. Residents rated clerks higher than faculty members on five ward components. Faculty ratings were poorly correlated with resident ratings. Faculty members and residents gave different ratings to the same students in contrast to the similarities in which faculty members and residents gave weight to the ward component ratings. Resident ratings were better than faculty ratings in predicting the NBME Surgery subscore. Although these results suggest that residents are better evaluators of a clerk's performance than are faculty members, other studies indicated the opposite. The elimination of participation of either faculty or residents in the grading of students is unwise. Periodic monitoring of evaluation practices is necessary to ensure fairness in grading procedures.
收集了163名完成外科实习学生的数据，包括病例书写得分、病房表现评估、口试成绩以及美国医学考试委员会（NBME）外科科目分项得分。口试成绩和病例书写由教员从74分（不及格）到100分（优秀）进行评分。病房表现评估包括对病房表现九个组成部分从1分（不满意）到4分（优秀）的评分以及病房总体得分从74分（不及格）到100分（优秀）。发现了评估者看待实习生方式上的异同。教员和住院医师对病房组成部分评分与病房总体得分的权重是相同的。住院医师在五个病房组成部分上对实习生的评分高于教员。教员评分与住院医师评分相关性较差。与教员和住院医师对病房组成部分评分权重的相似性形成对比的是，他们对同一名学生给出了不同的评分。住院医师评分在预测NBME外科科目分项得分方面优于教员评分。尽管这些结果表明住院医师比教员更能评估实习生的表现，但其他研究结果却相反。不让教员或住院医师参与学生评分是不明智的。定期监测评估做法对于确保评分程序的公平性是必要的。
