Grade Appeals in the Internal Medicine Clerkship: A National Survey and Recommendations for Improvement

Packer, Clifford D.; Duca, Nicholas S.; Dhaliwal, Gurpreet; Ismail, Nadia; Pincavage, Amber T.; Kisielewski, Michael; DeWaay, Deborah; Walsh, Katherine; Lai, Cindy J.

doi:10.1016/j.amjmed.2021.02.002

Cited by 4 publications

(2 citation statements)

References 8 publications

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“…10 One measure of student concern, the grade challenge rate, has been described in other clerkships as ranging from 4.5% to 8.0% of students in a given year. 11,12 Family medicine clerkships may be especially subject to student concerns about fairness, given the diversity of academic, community, and volunteer faculty who perform clinical assessments. Grade inflation has been identified as a particular challenge for family medicine clerkship directors (FMCDs).…”

Section: Introductionmentioning

confidence: 99%

Imprecise Clinical Assessments and Inaccurate Grades: Family Medicine Clerkship Director Perspectives

Sarkar,

Heidelbaugh,

Hallbauer

et al. 2024

Fam Med

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Background and Objectives: As application to residency programs becomes increasingly competitive, educational leaders face growing student concern about imprecise clinical assessments and clerkship grades. Methods: As part of a large annual survey of family medicine clerkship directors (FMCDs), 10 questions were disseminated in May 2023 about perceived levels of imprecise assessments by faculty. We aimed to determine to what extent respondents felt their institution’s evaluation system propagated inaccurate grading. Results: A total of 52% of 169 FMCDs responded to the survey. Of these, 7% of respondents were completely confident that their preceptors would give two students of identical competence the same clinical evaluation rating. FMCDs estimated that an average of 38% of their preceptors inaccurately rate student performance. Most clerkships use an Honors/High Pass/Pass/Fail grading system. We found that 51% of FMCDs prefer to use a different grading paradigm than they currently use. We asked FMCDs to estimate the percentage of students that expressed concern over inaccurate preceptor ratings. Grading systems with more tiers were associated with a higher percentage of concerned students. Conclusions: Clerkship grades are widely used by residency program directors to classify and differentiate student applicants. We identified a significant concern from FMCDs that clinical evaluation ratings can vary greatly. Given the high stakes and perceived inaccuracy of clerkship grading, we recommend continued investigation into the appropriate weighing and usage of clinical evaluations. Continued exploration is recommended to develop grading paradigms centered on criterion-based assessment.

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Section: Introductionmentioning

confidence: 99%

Imprecise Clinical Assessments and Inaccurate Grades: Family Medicine Clerkship Director Perspectives

Sarkar,

Heidelbaugh,

Hallbauer

et al. 2024

Fam Med

View full text Add to dashboard Cite

show abstract

“…2 Contemporaneously, clerkship grade appeals were becoming noticeable enough to clerkship directors in medicine (CDIM) and psychiatry that national surveys were conducted to begin to quantify the prevalence of these appeals and try to understand reasons for them. 3,4 In noting that significant institutional resources were being expended in addressing the present levels of student grade appeals, our group sought to extend the literature by engaging in a systematic analysis of grade appeals across 6 medical schools.…”

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confidence: 99%