Hunt D D, MacLaren C F, Scott C S, Chu J, Leiden L I
Department of Psychiatry and Behavioral Sciences, School of Medicine, SC-64, University of Washington, Seattle 98195.
Acad Med. 1993 Dec;68(12):905-11. doi: 10.1097/00001888-199312000-00011.
To compare results from 1981 and 1992 national surveys of the writers of medical school dean's letters, and to rate the 1992 letters based on the guidelines recommended by the Association of American Medical Colleges (AAMC).
In early 1992 a survey was administered to the dean's letter writers at all 125 U.S. medical schools with fully accredited four-year programs; the survey incorporated many items from a 1981 survey. In addition, 550 dean's letters from all U.S. medical schools for the graduating class of 1992 were collected and rated based on guidelines published by the AAMC in 1989.
The response rate of the 1992 survey was comparable to that of the 1981 survey (85% and 87%, respectively). In both surveys, slightly more than half the schools used more than one letter writer; however, the 1992 letters were longer and there were more of them, in spite of the fact that there were approximately 700 fewer graduates. In 1992 the estimated total cost per school was $25,000 (comparable data were not collected in 1981). The ratings of the letters revealed that only 38% of the schools introduced their letters as letters of "evaluation," as recommended by the AAMC, and that 15% of the schools failed to use the AAMC guidelines for format. When the schools were rated for overall quality (i.e., format combined with information about the students' performance in comparison with that of peers), 55% of the schools passed and 45% failed.
Several recommendations for improving dean's letters are discussed, including the following: (1) all dean's letters should be formatted according to the AAMC guidelines; (2) each school should have one person responsible for central overview of the school's letters; and (3) for comparative performance information, schools should at least give the percentages of grades given in the required clerkships, and it would be preferable for them to employ systems that group students into four to six groups and to indicate the percentage of students in each group.
比较1981年和1992年对医学院院长推荐信撰写者进行的全国性调查结果，并根据美国医学院协会（AAMC）推荐的指南对1992年的推荐信进行评级。
1992年初，对美国所有125所拥有完全认证的四年制课程的医学院的院长推荐信撰写者进行了一项调查；该调查纳入了1981年调查中的许多项目。此外，收集了美国所有医学院为1992届毕业生撰写的550封院长推荐信，并根据AAMC 1989年发布的指南进行评级。
1992年调查的回复率与1981年调查的回复率相当（分别为85%和87%）。在两项调查中，略多于一半的学校使用了不止一位推荐信撰写者；然而，1992年的推荐信更长，数量也更多，尽管毕业生人数大约少了700人。1992年，每所学校的估计总成本为25,000美元（1981年未收集可比数据）。对推荐信的评级显示，只有38%的学校按照AAMC的建议将其信件作为“评估”信引入，15%的学校未使用AAMC的格式指南。当对学校的整体质量进行评级时（即格式与关于学生与同龄人相比的表现信息相结合），55%的学校通过，45%的学校未通过。
讨论了一些改进院长推荐信的建议，包括以下几点：（1）所有院长推荐信应按照AAMC指南进行格式编排；（2）每所学校应指定一人负责对学校的信件进行总体审查；（3）对于比较表现信息，学校应至少给出必修实习课程中所给成绩的百分比，并且最好采用将学生分为四至六组并指明每组学生百分比的系统。
