What do faculty observe of medical students' clinical performance?

Background: An earlier study of our faculty's evaluation of junior medical students indicated that performance ratings were unreliable and reflected 1 underlying dimension. Other researchers have obtained similar results. Purpose: The purpose of this study was to identify which aspects of students' clinical performance faculty actually observe. Methods: We analyzed the responses of faculty members to an open-ended questionnaire concerning which aspects of clinical performance attending faculty observe. We also reviewed and summarized the written comments of 331 faculty evaluations of third-year medical students. Results: Analysis of the questionnaires and evaluations indicated that faculty members gauge medical knowledge, professionalism, and clinical reasoning skills from direct interaction with students. History taking and physical examination skills are inferred from the quality of verbal presentations. Faculty have little basis for evaluating other important aspects of clinical performance. Conclusions: Faculty primarily observe medical students cognitive skills and professionalism. Faculty have little basis for evaluating most other features of clinical performance.