An AAMC pilot study by 10 medical schools of clinical evaluation of students

In 1979 the Association of American Medical Colleges (AAMC) began a Clinical Evaluation Program. In the first phase of the program, AAMC staff members interviewed more than 500 persons in approximately 40 medical schools and solicited responses from clerkship coordinators in six specialties on the problems encountered in evaluating students' clinical performance. These results were published in 1983. The second phase of the program, which is reported on in the present paper, consisted of developing a set of self-assessment instruments in clinical evaluation and testing these instruments by 10 pilot schools. Clinical faculty members and clerkship coordinators in the pilot schools and residents at affiliated hospitals who worked with the students were asked to identify the problems they faced in evaluating students' clinical performance, and these responses were analyzed in terms of the respondents' specialties. The problems identified by the highest percentages of clinical faculty members and residents were: inadequate guidelines for handling problem students, failure to act on negative evaluations, lack of information about problems that students bring with them into clerkships, and faculty members' unwillingness to record negative evaluations. A rank-ordering of these responses on problems showed that different specialties considered different problems to be severe. In rating difficulties in evaluating problem students, the respondents reported that the type of problem student most frequently encountered was one who cannot focus on what is important. Rank-ordering of these responses showed that each type of problem student poses different evaluation difficulties in each specialty. The respondents also identified the problems they had with the evaluation forms used in their departments.