title: The reliability of in-training assessment when performance improvement is taken into account.
abstract: During in-training assessment students are frequently assessed over a longer period of time and therefore it can be expected that their performance will improve. We studied whether there really is a measurable performance improvement when students are assessed over an extended period of time and how this improvement affects the reliability of the overall judgement. In-training assessment results were obtained from 104 students on rotation at our university hospital or at one of the six affiliated hospitals. Generalisability theory was used in combination with multilevel analysis to obtain reliability coefficients and to estimate the number of assessments needed for reliable overall judgement, both including and excluding performance improvement. Students' clinical performance ratings improved significantly from a mean of 7.6 at the start to a mean of 7.8 at the end of their clerkship. When taking performance improvement into account, reliability coefficients were higher. The number of assessments needed to achieve a reliability of 0.80 or higher decreased from 17 to 11. Therefore, when studying reliability of in-training assessment, performance improvement should be considered.
authors.affiliation: Center for Research and Innovation in Medical Education, University of Groningen and University Medical Center Groningen, A. Deusinglaan 1, 9713 AV, Groningen, The Netherlands. m.t.van.lohuizen@med.umcg.nl
authors.forename: Mirjam T
authors.initials: MT
authors.lastname: van Lohuizen
authors.forename: Jan B M
authors.initials: JB
authors.lastname: Kuks
authors.forename: Elisabeth A
authors.initials: EA
authors.lastname: van Hell
authors.forename: A N
authors.initials: AN
authors.lastname: Raat
authors.forename: Roy E
authors.initials: RE
authors.lastname: Stewart
authors.forename: Janke
authors.initials: J
authors.lastname: Cohen-Schotanus
mesh_terms: D002982:Clinical Clerkship; D002983:Clinical Competence; D016001:Confidence Intervals; D004504:Education, Medical, Undergraduate / Q000592:standards / Q000706:statistics & numerical data*; D004521:Educational Measurement; D004522:Educational Status; D006801:Humans; D016013:Likelihood Functions; D008137:Longitudinal Studies; D009426:Netherlands; D015203:Reproducibility of Results; D013337:Students, Medical / Q000706:statistics & numerical data*