Kathryn L Butler1, David A Hirsh2, Emil R Petrusa3, D Dante Yeh3, Dana Stearns4, David E Sloane5, Jeffrey A Linder5, Gaurab Basu6, Lisa A Thompson7, Marc A de Moya3. 1. Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts. Electronic address: klbutler@partners.org. 2. Cambridge Health Alliance, Cambridge, Massachusetts; Department of Medicine, Harvard Medical School, Boston, Massachusetts. 3. Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts. 4. Department of Emergency Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts. 5. Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts. 6. Department of Medicine, Cambridge Health Alliance and Harvard Medical School, Cambridge, Massachusetts. 7. Harvard School of Dental Medicine, Cambridge, Massachusetts.
Abstract
OBJECTIVE: Optimal methods for medical student assessment in surgery remain elusive. Faculty- and housestaff-written evaluations constitute the chief means of student assessment in medical education. However, numerous studies show that this approach has poor specificity and a high degree of subjectivity. We hypothesized that an objective structured clinical examination (OSCE) in the surgery clerkship would provide additional data on student performance that would confirm or augment other measures of assessment. DESIGN: We retrospectively reviewed data from OSCEs, National Board of Medical Examiners shelf examinations, oral presentations, and written evaluations for 51 third-year Harvard Medical School students rotating in surgery at Massachusetts General Hospital from 2014 to 2015. We expressed correlations between numeric variables in Pearson coefficients, stratified differences between rater groups by one-way analysis of variance, and compared percentages with 2-sample t-tests. We examined commentary from both OSCE and clinical written evaluations through textual analysis and summarized these results in percentages. RESULTS: OSCE scores and clinical evaluation scores correlated poorly with each other, as well as with shelf examination scores and oral presentation grades. Textual analysis of clinical evaluation comments revealed a heavy emphasis on motivational factors and praise, whereas OSCE written comments focused on cognitive processes, patient management, and methods to improve performance. CONCLUSIONS: In this single-center study, an OSCE provided clinical skills data that were not captured elsewhere in the surgery clerkship. Textual analysis of faculty evaluations reflected an emphasis on interpersonal skills, rather than appraisal of clinical acumen. These findings suggest complementary roles of faculty evaluations and OSCEs in medical student assessment.
OBJECTIVE: Optimal methods for medical student assessment in surgery remain elusive. Faculty- and housestaff-written evaluations constitute the chief means of student assessment in medical education. However, numerous studies show that this approach has poor specificity and a high degree of subjectivity. We hypothesized that an objective structured clinical examination (OSCE) in the surgery clerkship would provide additional data on student performance that would confirm or augment other measures of assessment. DESIGN: We retrospectively reviewed data from OSCEs, National Board of Medical Examiners shelf examinations, oral presentations, and written evaluations for 51 third-year Harvard Medical School students rotating in surgery at Massachusetts General Hospital from 2014 to 2015. We expressed correlations between numeric variables in Pearson coefficients, stratified differences between rater groups by one-way analysis of variance, and compared percentages with 2-sample t-tests. We examined commentary from both OSCE and clinical written evaluations through textual analysis and summarized these results in percentages. RESULTS: OSCE scores and clinical evaluation scores correlated poorly with each other, as well as with shelf examination scores and oral presentation grades. Textual analysis of clinical evaluation comments revealed a heavy emphasis on motivational factors and praise, whereas OSCE written comments focused on cognitive processes, patient management, and methods to improve performance. CONCLUSIONS: In this single-center study, an OSCE provided clinical skills data that were not captured elsewhere in the surgery clerkship. Textual analysis of faculty evaluations reflected an emphasis on interpersonal skills, rather than appraisal of clinical acumen. These findings suggest complementary roles of faculty evaluations and OSCEs in medical student assessment.
Authors: Andrew S Parsons; Kelley Mark; James R Martindale; Megan J Bray; Ryan P Smith; Elizabeth Bradley; Maryellen Gusic Journal: J Gen Intern Med Date: 2022-06-16 Impact factor: 6.473
Authors: Carlos Theodore Huerta; Rebecca A Saberi; Chad M Thorson; Vanessa W Hui; Steven E Rodgers; Laurence R Sands Journal: J Surg Educ Date: 2022-10-11 Impact factor: 3.524