Thompson Meredith, Rivera Megan, Katz Jeffrey, Maldonado Nicholas, Srihari Caroline, Marchick Michael, Fernandez Rosemarie
Department of Emergency Medicine University of Florida Gainesville Florida USA.
Department of Emergency Medicine Duke University Durham North Carolina USA.
AEM Educ Train. 2024 Jul 22;8(4):e11012. doi: 10.1002/aet2.11012. eCollection 2024 Aug.
Assessment of medical students in the clinical learning environment is fraught with challenges. Seemingly small variations in clinical clerkship evaluation can significantly impact a student's future. As such, the integrity of the grade selection process must be heavily scrutinized. Group decision making in the form of a clerkship grading committee may be part of a solution to address this complex problem.
We conducted a retrospective observational study to describe grading committee decisions for a required fourth-year EM clerkship from August 2021 to April 2022. Literature on best practices for group decision making and assessment were reviewed. This informed the development and implementation of the committee process. Each committee meeting was video recorded and coded for discussion time per student, times the committee grade differed from historical-grade cutoffs with reasoning, and the frequency a committee member voiced a first-hand account of student performance.
Data from nine meetings was reviewed (86 students). The mean discussion time per student was 2 min 13 s (range 11 s to 9 min 22 s). The final committee decision differed from historical-grade cutoffs for nine students (10%), six were adjusted above and three below. In 64% (55/86) of student reviews a committee member voiced a first-hand experience of working with the student. Positive grade adjustments were made due to outlier evaluations and negative adjustments were made for professionalism concerns.
Grading committees are a means to conduct a comprehensive review of student performance and offer shared ownership of the grade decision among committee members. More study is needed to directly determine their potential benefit and role in clerkship grading.
在临床学习环境中评估医学生充满挑战。临床实习评估中看似微小的差异可能会对学生的未来产生重大影响。因此，成绩评定过程的公正性必须受到严格审查。以实习评分委员会形式进行的集体决策可能是解决这一复杂问题的部分方案。
我们进行了一项回顾性观察研究，以描述2021年8月至2022年4月期间四年级急诊医学必修实习的评分委员会决策。回顾了关于集体决策和评估最佳实践的文献。这为委员会流程的制定和实施提供了参考。每次委员会会议都进行了视频录制，并对每个学生的讨论时间、委员会给出的成绩与历史成绩临界值不同的次数及理由，以及委员会成员提及学生表现第一手情况的频率进行了编码。
审查了九次会议的数据（86名学生）。每个学生的平均讨论时间为2分13秒（范围为11秒至9分22秒）。委员会的最终决定与九名学生（10%）的历史成绩临界值不同，六名学生的成绩被调高，三名被调低。在64%（55/86）的学生评估中，委员会成员提及了与该学生共事的第一手经历。因异常评估进行了积极的成绩调整，因职业素养问题进行了消极调整。
评分委员会是全面审查学生表现并让委员会成员共同参与成绩决定的一种方式。需要更多研究来直接确定它们在实习评分中的潜在益处和作用。
