title: Peer nomination: a tool for identifying medical student exemplars in clinical competence and caring, evaluated at three medical schools.
abstract: OBJECTIVE
  Peer evaluation is underused in medical education. The goals of this study were to validate in a multiinstitutional study a peer nomination form that identifies outstanding students in clinical competency and interpersonal skills, to test the hypothesis that with additional survey items humanism could be identified as a separate factor, and to find the simplest method of analysis.
  
  
  METHODS
  In 2003, a 12-item peer nomination form was administered to junior or senior medical students at three institutions. Factor analysis was used to identify major latent variables and the items related to those characteristics. On the basis of those results, in 2004 a simpler, six-item form was developed and administered. Student rankings based on factor analysis and nomination counts were compared.
  
  
  RESULTS
  Factor analysis of peer nomination data from both surveys identified three factors: clinical competence, caring, and community service. New survey items designed to address humanism are all weighted with interpersonal skills items; thus, the second major factor is characterized as caring. Rankings based on peer nomination results analyzed by either factor analysis or simply counting nominations distinguish at least the top 15% of students for each characteristic.
  
  
  CONCLUSIONS
  Counting peer nominations using a simple, six-item form identifies medical student exemplars for three characteristics: clinical competence, caring, and community service. Factor analysis of peer nomination data did not identify humanism as a separate factor. Peer nomination rankings provide medical schools with a reliable tool to identify exemplars for recognition in medical student performance evaluations and selection for honors (e.g., Gold Humanism Honor Society).
authors.affiliation: Department of Pathology, Immunology & Laboratory Medicine, University of Florida College of Medicine, Gainesville, Florida 32610-0215, USA.
authors.forename: Wayne T
authors.initials: WT
authors.lastname: McCormack
authors.forename: Cathy
authors.initials: C
authors.lastname: Lazarus
authors.forename: David
authors.initials: D
authors.lastname: Stern
authors.forename: Parker A
authors.initials: PA
authors.lastname: Small
mesh_terms: D002982:Clinical Clerkship; D002983:Clinical Competence; D004504:Education, Medical, Undergraduate / Q000379:methods*; D004521:Educational Measurement / Q000379:methods; D006801:Humans; D010380:Peer Review / Q000379:methods*; D011361:Professional Competence; D013337:Students, Medical