Evaluation of student performance: clinical and professional performance.

In 1999, the Accreditation Council for Graduate Medical Education (ACGME) endorsed six general competencies for residents as part of an ongoing attempt to emphasize educational outcomes as part of residency program assessment and accreditation. Although the focus of these reforms has been on postgraduate training, the competencies are applicable to medical students who aspire to become excellent clinicians and can help guide the development of assessment tools to measure clinical and professional performance of students in the emergency department. This article reviews the definitions of clinical competence and briefly addresses the issues of evaluation tool validity, reliability, and feasibility as they relate to the assessment of medical students. Several assessment tools are outlined, with an eye to the ACGME competencies and the ACGME Toolbox of Assessment Methods. The pros and cons of global rating scales, direct observation, simulations, and oral examinations are reviewed. Multiple assessment tools are often necessary to provide a true evaluation of a student's clinical and professional skills. Their application in the setting of an emergency medicine rotation is described and discussed.