Evaluation, grading, and use of the RIME vocabulary on internal medicine clerkships: results of a national survey and comparison to other clinical clerkships.
BACKGROUND
Evaluation methods within and across clerkships are rapidly evolving, including greater emphasis or frameworks for descriptive evaluation and direct observation of competence.


OBJECTIVE
The purpose of this study is to describe current evaluation methods, use of the Reporter-Interpreter-Manager/Educator (RIME) framework, and grade assignment by internal medicine clerkship directors.


METHODS
In 2005, the Clerkship Directors in Internal Medicine surveyed its 109 institutional members. Topics included evaluation methods and grade contribution, use of evaluation sessions and/or RIME, and grade assignment (criterion referenced or normative).


RESULTS
Response rate was 81% (88/109). The evaluation methods were as follows: teachers' evaluations, 93% (64% of grade); National Board of Medical Examiners subject examination, 81% (25% of grade); faculty written exam, 34% (14% of grade); objective structured clinical examinations, 32% (12% of grade); direct observation, 22% (7% of grade). RIME is used by 42% of respondents. Many clerkship directors (43%) meet with teachers to discuss student performance. Criterion-referenced grading is used by 59%, and normative grading is used by 27%. Unsatisfactory grades are given for examination failures (72%), unprofessional behavior (49%), poor clinical performance (42%), and failure to meet requirements (18%).


CONCLUSIONS
Internal medicine clerkship directors emphasize description and observation of students. RIME and discussions with teachers are becoming commonplace.
Hemmer
Paul A
PA
Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland 20814, USA. phemmer@usuhs.mil
Papp
Klara K
KK
Mechaber
Alex J
AJ
Durning
Steven J
SJ
D000328:Adult; D002982:Clinical Clerkship / Q000592:standards*; D002983:Clinical Competence / Q000592:standards*; D004521:Educational Measurement / Q000379:methods*; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007388:Internal Medicine; D008297:Male; D008875:Middle Aged; D009626:Terminology as Topic; D014481:United States