What Do Faculty Observe of Medical Students' Clinical Performance?

BACKGROUND: An earlier study of our faculty's evaluation of junior medical students indicated that performance ratings were unreliable and reflected 1 underlying dimension. Other researchers have obtained similar results. PURPOSE: The purpose of this study was to identify which aspects of students' clinical performance faculty actually observe. METHODS: We analyzed the responses of 9 faculty members to an open-ended questionnaire concerning which aspects of clinical performance attending faculty observe. We also reviewed and summarized the written comments of 331 faculty evaluations of third-year medical students. RESULTS: Analysis of the questionnaires and evaluations indicated that faculty members gauge medical knowledge, professionalism, and clinical reasoning skills from direct interaction with students. History-taking and physical examination skills are inferred from the quality of verbal presentations. Faculty have little basis for evaluating other important aspects of clinical performance. CONCLUSIONS: Faculty primarily observe medical students' cognitive skills and professionalism. Faculty have little basis for evaluating most other features of clinical performance.