Are Clerkship Clinical Grades Fair? (or, “I Want That Male Intern To Evaluate Me.”)

Grading: The authors investigated the influence of student and evaluator demographics on the summary clinical grades given to 155 clerkship students at one medical school.  The possible grades were “exceptional”, “above expectations”, “meets expectations”, and “below expectations”.  Newcomers to student evaluation may be startled by the strong “Lake Woebegone” effect:  only 16 of 4,462 evaluations were “below expectations” and only 12-23%, depending on the clerkship, were “meets expectations”.   It is not surprising, but of concern, that variables outside of the students’ control appeared to have a moderate to large effect on the clinical grade assigned.  The authors focus on the gender effects:  Male students were graded lower than female students, but only when being evaluated by female residents or attendings.  Male evaluators , but not female evaluators, became much more stringent graders with increasing age. However, another variable had an even larger effect on grade.  Observation times of >1 day were associated with a much higher rate of “exceptional” ratings.  Gender effects on evaluations, including evaluations by standardized patients, have been seen in the prior studies.  Clerkship directors may need to keep these influences in mind. — Laura Willett, MD

Riese A, Rappaport L, Alverson B, Park S, Rockney RM. Clinical Performance Evaluations of Third-Year Medical Students and Association With Student and Evaluator Gender. Acad Med. 2017 Jan 17.

Link To Article

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