Characteristics of dean's letters in 1981 and 1992.

PURPOSE: To compare results from 1981 and 1992 national surveys of the writers of medical school dean's letters, and to rate the 1992 letters based on the guidelines recommended by the Association of American Medical Colleges (AAMC). METHOD: In early 1992 a survey was administered to the dean's letter writers at all 125 U.S. medical schools with fully accredited four-year programs; the survey incorporated many items from a 1981 survey. In addition, 550 dean's letters from all U.S. medical schools for the graduating class of 1992 were collected and rated based on guidelines published by the AAMC in 1989. RESULTS: The response rate of the 1992 survey was comparable to that of the 1981 survey (85% and 87%, respectively). In both surveys, slightly more than half the schools used more than one letter writer; however, the 1992 letters were longer and there were more of them, in spite of the fact that there were approximately 700 fewer graduates. In 1992 the estimated total cost per school was $25,000 (comparable data were not collected in 1981). The ratings of the letters revealed that only 38% of the schools introduced their letters as letters of "evaluation," as recommended by the AAMC, and that 15% of the schools failed to use the AAMC guidelines for format. When the schools were rated for overall quality (i.e., format combined with information about the students' performance in comparison with that of peers), 55% of the schools passed and 45% failed. CONCLUSION: Several recommendations for improving dean's letters are discussed, including the following: (1) all dean's letters should be formatted according to the AAMC guidelines; (2) each school should have one person responsible for central overview of the school's letters; and (3) for comparative performance information, schools should at least give the percentages of grades given in the required clerkships, and it would be preferable for them to employ systems that group students into four to six groups and to indicate the percentage of students in each group.

Assessing learning-style inventories and how well they predict academic performance.

In the fall of 1988, 79 students at the University of Nevada School of Medicine were administered two learning-style inventories: the Lancaster Approaches to Studying Inventory (LASI) and the Inventory of Learning Processes (ILP). Students' scores on these scales were examined in terms of the theoretical distinction between deep and surface approaches to learning. The data provided strong support for this distinction, with the scores on learning-style measures correlating as expected. The relationships between the students' inventory scores and their scores on two measures of academic performance were also examined. Correlations between measures of learning style and academic performance yielded low, nonsignificant positive correlations and were found to be inadequate predictors of academic performance. Implications and possible explanations for these findings are discussed.

National survey of writers of dean's letters for residency applications.

The purpose of the study reported here was to provide descriptive information about dean's letters, which are comprehensive summary letters sent near the end of students' undergraduate medical training by medical school deans to be part of the students' residency applications. Deans of student affairs at 124 U.S. medical schools were surveyed regarding composition of these letters at their institution. They were asked to describe themselves and the letters they write. Responses were received from 87 percent of these schools and provided data on types of information included in the letters, the decision to edit evaluations, student participation in the letter-writing process, use of final summary statements, cost and length of letters, and attitudes toward the development of national letter-writing guidelines. Major findings of the survey show that 97 percent of the writers allocated more space for clinical evaluations than basic science evaluations. Less than 50 percent of the writers included the student's class rank. Almost all included narrative evaluations of the student's performance during the clinical years. Negative information on students was addressed inconsistently by the writers. Eighty-five percent of the writers categorized their students in final summary statements, but many of these failed to provide descriptions of the categories used or explanatory data. The present authors make recommendations for writing more credible and useful letters.

Perceived stress in medical, law, and graduate students.

Students in the medical and law schools and graduate students in chemistry and psychology at a single institution were asked to complete a questionnaire about events and activities related to their educational programs which they perceived to be stressful. The questionnaire was designed to elicit information about stress associated with academic activities, personal relationships, time pressures, and financial concerns. Information was also obtained about time utilization, health behaviors, crises, and support systems. The authors' hypothesis that medical students would report higher perceived stress levels than students in the other programs was not supported, as the highest total stress score was reported by law students. Factor analysis of a 31-item stress scale produced six separate factors pertaining to the sources of stress: academic concerns, time concerns, fear of failing, classroom interactions, economic issues, and world issues. Time restrictions and economic and academic issues had the highest mean stress scores. The hypotheses by the authors that students would report program-specific stresses and that utilization of support services would differ among the four groups of students were both supported. Implications of these findings are discussed.