title: Medical students' clinical performance in general practice - Triangulating assessments from patients, teachers and students.
abstract: BACKGROUND
  Formative assessment of medical students' clinical performance during general practice clerkship is necessary to learn consultation skills.
  
  
  OBJECTIVE
  Our aim was to triangulate feedback using patient questionnaires, written self-assessment and teachers' observation-based assessment, and to describe the content of this feedback.
  
  
  METHODS
  We developed StudentPEP, a 15-item version of EUROPEP, a tool for measuring patients' evaluation of quality in general practice. The teacher and student forms consisted of five StudentPEP-items and open-ended questions asking for approval and improvement needed on four aspects. Quantitative scores were analyzed statistically. Free-text comments were analyzed and categorized into 'specific and concrete' versus 'general and unspecific'.
  
  
  RESULTS
  One hundred seventy-three students returned data from 2643 consultations. Mean patients' scores for 15 items were 4.3-4.8 on a five-point Likert scale. Mean teacher scores were 4.4 on five items, while students' mean self-assessments were 3.6-3.8. In an analysis of 380 consultations, students were more specific and concrete in their self-evaluation compared with teachers (p < 0.01).
  
  
  CONCLUSIONS
  Patients scored students' performance high compared with students' self-assessments. Teachers' scores were in accordance with patients' scores. Teachers' written evaluations of students were often general. There is a potential for improving teachers' feedback in terms of more specific and concrete comments.
authors.affiliation: University of Oslo, Blindern, N-0318 Oslo, Norway.
authors.forename: Anja Maria
authors.initials: AM
authors.lastname: Braend
authors.forename: Sarah Frandsen
authors.initials: SF
authors.lastname: Gran
authors.forename: Jan C
authors.initials: JC
authors.lastname: Frich
authors.forename: Morten
authors.initials: M
authors.lastname: Lindbaek
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002983:Clinical Competence / Q000592:standards*; D005180:Faculty, Medical; D005194:Family Practice; D005246:Feedback; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009664:Norway; D019370:Observation; D017060:Patient Satisfaction; D013337:Students, Medical; D011795:Surveys and Questionnaires; D055815:Young Adult