Use of objective examinations in medicine clerkships. Ten-year experience.

Student performance during the internal medicine clerkship at the University of Washington School of Medicine has been evaluated by clinical ratings and a written examination containing multiple-choice questions and patient management problems for the past 10 years. Measures of the correlation among the evaluation methods were determined by analyzing data from 1,544 students. The correlations of clinical ratings with the total examination score (r = 0.27), multiple-choice questions (r = 0.23), and patient management problems (r = 0.19) suggest that clinical ratings alone are not adequate for measuring student progress. The relationships of evaluation methods used in the medicine clerkship to other measures of performance such as selection to Alpha Omega Alpha and National Board examinations were also determined. The ability to predict student performance was enhanced considerably when the results of the clerkship examination were considered in addition to clinical ratings. These data suggest that a comprehensive assessment of student performance in medicine clerkships should include written examinations in addition to clinical ratings.

Predicting performance during clinical years from the new Medical College Admission Test.

The results of a predictive validity study of the new Medical College Admission Test (MCAT) using criteria from the clinical years of undergraduate medical education are presented and discussed. The criteria included course grades and faculty ratings of clerks in internal medicine, surgery, obstetrics and gynecology, pediatrics, and psychiatry; scores on a comprehensive test of clinical knowledge (including patient management type examinations); and scores on Part II of the examinations of the National Board of Medical Examiners (NBME). While the validity coefficients of the MCAT with the Part II examinations ranged from .03 to .47, they were higher than those of undergraduate grade-point averages with the same criteria. The implications of the small-to-medium size validity coefficients for admissions are discussed.

The use of student ratings in multiinstructor courses.

In this study the authors examined the efficacy of using student ratings of teaching effectiveness in multiinstructor courses. Specific issues addressed included student ability to identify differences in faculty teaching effectiveness, the consistency of student rating obtained immediately following each lecture with those obtained at the conclusion of the course, and the relationship between individual faculty ratings and overall course ratings. A random sample of students rated each of 14 lectures in a psychopathology course using a 13-item rating scale immediately after each lecture and again at the end of the course. Results indicated that differences in faculty teaching effectiveness are measurable, ratings of individual faculty are relatively stable over over time, and rating of individual faculty are separable from those of the course as a whole. Implications of this research for use of student ratings are also discussed.