title: A comparison of performance evaluations of students on longitudinal integrated clerkships and rotation-based clerkships.
abstract: BACKGROUND
  Longitudinal integrated clerkship (LIC) students typically perform as well as, if not better than, rotation-based clerkship (RBC) students on objective evaluations, yet few studies have compared performance in the clinical setting. This study compared in-training evaluation report (ITER) ratings of LIC and RBC students, including their correlation with more objective evaluations.
  
  
  METHODS
  On the basis of prior academic performance, LIC students (n = 27) at Universities of Alberta, British Columbia, and Calgary were matched with four RBC students from their center. The authors compared reliability of ITER ratings, ITER ratings of clinical skills and professional attributes, and the correlation between ITER ratings and objective evaluations of clinical skills and professional attributes on the Medical Council of Canada Qualifying Examination (MCCQE) Part I.
  
  
  RESULTS
  ITER ratings of LIC students were more reliable and significantly higher than those of RBC students for both clinical skills and professional attributes. However, LIC students had lower objective structured clinical examination scores and weaker correlations between subjective and objective evaluations of clinical skills. By comparison, LIC students scored higher on a particular component of the MCCQE and had stronger correlations between subjective and objective evaluations of professionalism.
  
  
  CONCLUSIONS
  The discrepancy between ratings of LIC students' clinical skills on ITER and other evaluation formats may be due to differences between the content of training and objective evaluations, or systematic rater biases. Further studies are needed to confirm and explain these findings. Promisingly, our data suggest that the LIC model may allow for a more predictive evaluation of professional competencies.
authors.affiliation: Office of Undergraduate Medical Education, University of Calgary, Health Sciences Centre, 3330 Hospital Drive NW, Calgary, Alberta, Canada T2N 4N1. kmclaugh@ucalgary.ca
authors.forename: Kevin
authors.initials: K
authors.lastname: McLaughlin
authors.forename: Joanna
authors.initials: J
authors.lastname: Bates
authors.forename: Jill
authors.initials: J
authors.lastname: Konkin
authors.forename: Wayne
authors.initials: W
authors.lastname: Woloschuk
authors.forename: Carol A
authors.initials: CA
authors.lastname: Suddards
authors.forename: Glenn
authors.initials: G
authors.lastname: Regehr
mesh_terms: D000416:Alberta; D001955:British Columbia; D002982:Clinical Clerkship / Q000379:methods*; D002983:Clinical Competence; D015331:Cohort Studies; D004521:Educational Measurement; D011446:Prospective Studies