Influence of clerkship structure and timing on individual student performance

Article Abstract:

Surgical clerkships are often part of the medical school curriculum. Students' experiences during this clerkship vary. Clerkships may be done at different times of the year, take place in different hospital settings, and involve various general and subspecialty experience. Student performance evaluations are often both written and oral. An evaluation of surgical clerkships was undertaken to determine if certain factors influenced a student's evaluation scores. The factors considered were: the calendar block when clerkship was performed; site (university hospital, affiliated hospital, or rural preceptor experience with an individual physician); and mix of general surgical versus subspecialty rotations. There were 139 students in the clerkship evaluated. The only factor that influenced evaluation score was the block of time in which the clerkship was done. This was due to score differences on the written test. December-February and March-May blocks had higher scores than the June-August block. The student scores for their basic science courses did not vary among the groups, making intergroup difference an unlikely cause of the written score differences. The specialty mix encountered or the setting of the clerkship had no effect on either written or oral clerkship scores. A related editorial comment notes that the written examination (developed by a national board) might be inadequate for review based on local curriculum content. Also, factors other than curriculum might be responsible for the calendar block difference, such as other tests, clinical growth and improved problem-solving ability. Emphasis in clerkship must be upon general surgical principles within a uniform core curriculum. (Consumer Summary produced by Reliance Medical Information, Inc.)

Surgery, Curricula, Study and teaching

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Pass/fail grading: a disadvantage for students applying for residency

Article Abstract:

During the late 1960s and early 1970s a pass/fail grading system in medical school was looked upon as an alternative to the traditional letter grading. It was felt that grades stifled learning and that rather than learning for the sake of obtaining knowledge, students worked to ''get the grade''. Most medical schools have adopted pass/fail grading to reduce student anxiety and still maintain an acceptable method of student accountability. In practice today, however, many medical schools have added levels such as low pass, high pass and honors. A disadvantage of this pass/fail system is inadequate discrimination among the students who pass. With the current system is there still less pressure on students to compete? A poll was taken of directors of surgical residency programs to determine if the type of grading system used by a medical school seemed to influence a student's ability to compete for a residency position. The response rate for the questionnaire was 64 percent. Eighty-nine percent of those responding indicated they preferred to review student transcripts that provided letter grades. Additionally, 83 percent of the respondents said they would prefer to evaluate their own students using a letter grading system. This is consistent with the nationwide trend toward more objective evaluation in education. It was felt by 83 percent of the respondents that a student was adversely affected in his or her ability to compete for a residency position if he or she had been graded on a pass/fail system. These findings suggest that the pass/fail system places the medical student at a disadvantage when applying for a residency position. (Consumer Summary produced by Reliance Medical Information, Inc.)

Social aspects, Education, Residents (Medicine)

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Reliability of different grading systems used in evaluating surgical students

Article Abstract:

This study assessed the reliability of assigning grades to 16 medical students as rated by 21 different faculty members. The students were rated on the following scales: pass-fail-grading, pass-fail-honors, letter-grade, a number scale from one to 10 and a number scale from one to 100. Good discrimination and reliability were provided by the letter grade and one to 10 number grade systems. In terms of reliability, the letter grade system was found to be the best.

Case studies, Medical education policy

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