The feasibility and acceptability of implementing formal evaluation sessions and using descriptive vocabulary to assess student performance on a clinical clerkship

Background: A systematized approach to descriptive evaluation of clinical performance using a vocabulary of global descriptors in the setting of formal evaluation and feedback sessions has been shown to be reliable and valid. The feasibility of this method beyond the institution at which it was developed has not been studied. Purpose: To determine the feasibility and acceptability of implementing formal evaluation and feedback sessions, using a vocabulary of global descriptors, in a third-year core clinical clerkship. Methods: In 1997, the University, of Utah internal medicine clerkship introduced an evaluation method in which student performance was discussed at formal sessions, using a taxonomy of global terms describing progressive development from "reporter" to "interpreter" to "manager/educator" (R-I-M-E). The sessions were face-to-face meetings between the clinical teachers and a clerkship director, at three-week intervals through the twelve-week clerkship at the inpatient teaching sites, Following the evaluation session students met individually with the clerkship director for feedback. To determine feasibility, the authors estimated the time and resources necessary to administer the system and recorded actual teacher attendance over 2 academic years (1997-99). Anonymous surveys, using a four-point, Likert-type scale, were used to determine acceptance of the method by faculty, residents, and students. Results: Attendance was high for residents (79%) and faculty (72%). Mean survey responses from residents and faculty rated the descriptive system "more valid" than the previous method. A majority of the students rated the method as either "helpful" (30%) or "very helpful" (50%). Time requirement for eight to ten students at each teaching site, for evaluation and feedback sessions was one-half day per week of the clerkship director, every three weeks. Conclusion: Our experience establishes the feasibility of implementing this system of formal evaluation and feedback, using descriptive vocabulary, beyond the institution at which it was developed. Students, residents, and faculty endorsed this evaluation system and the survey results suggest substantial utility and face validity.