Resident and faculty differences in student evaluations: implications for changes in a clerkship grading system.

Data were collected for 163 students completing a surgical clerkship including scores on patient write-ups, ward performance evaluations, oral examinations, and National Board of Medical Examiners (NBME) Surgery subscores. Oral examination scores and patient write-ups were rated from 74 (failing) to 100 (honors) by faculty members. The ward performance evaluation included ratings on nine components of ward performance from 1 (unsatisfactory) to 4 (superior) and an overall ward score of 74 (failing) to 100 (honors). Similarities and discrepancies in the way that evaluators viewed clerks were found. Weights given to ward component ratings in relationship to the overall ward score were equivalent for faculty members and residents. Residents rated clerks higher than faculty members on five ward components. Faculty ratings were poorly correlated with resident ratings. Faculty members and residents gave different ratings to the same students in contrast to the similarities in which faculty members and residents gave weight to the ward component ratings. Resident ratings were better than faculty ratings in predicting the NBME Surgery subscore. Although these results suggest that residents are better evaluators of a clerk's performance than are faculty members, other studies indicated the opposite. The elimination of participation of either faculty or residents in the grading of students is unwise. Periodic monitoring of evaluation practices is necessary to ensure fairness in grading procedures.