title: Timing of Emergency Medicine Student Evaluation Does Not Affect Scoring.
abstract: BACKGROUND
  Evaluation of medical students rotating through the emergency department (ED) is an important formative and summative assessment method. Intuitively, delaying evaluation should affect the reliability of this assessment method, however, the effect of evaluation timing on scoring is unknown.
  
  
  OBJECTIVE
  A quality-improvement project evaluating the timing of end-of-shift ED evaluations at the University of Arizona was performed to determine whether delay in evaluation affected the score.
  
  
  METHODS
  End-of-shift ED evaluations completed on behalf of fourth-year medical students from July 2012 to March 2013 were reviewed. Forty-seven students were evaluated 547 times by 46 residents and attendings. Evaluation scores were means of anchored Likert scales (1-5) for the domains of energy/interest, fund of knowledge, judgment/problem-solving ability, clinical skills, personal effectiveness, and systems-based practice. Date of shift, date of evaluation, and score were collected. Linear regression was performed to determine whether timing of the evaluation had an effect on evaluation score.
  
  
  RESULTS
  Data were complete for 477 of 547 evaluations (87.2%). Mean evaluation score was 4.1 (range 2.3-5, standard deviation 0.62). Evaluations took a mean of 8.5 days (median 4 days, range 0-59 days, standard deviation 9.77 days) to complete. Delay in evaluation had no significant effect on score (p = 0.983).
  
  
  CONCLUSIONS
  The evaluation score was not affected by timing of the evaluation. Variance in scores was similar for both immediate and delayed evaluations. Considerable amounts of time and energy are expended tracking down delayed evaluations. This activity does not impact a student's final grade.
authors.affiliation: Department of Emergency Medicine, University of Arizona, Tuscon, Arizona.
authors.forename: Katherine M
authors.initials: KM
authors.lastname: Hiller
authors.affiliation: Department of Emergency Medicine, University of Arizona, Tuscon, Arizona.
authors.forename: Anna
authors.initials: A
authors.lastname: Waterbrook
authors.affiliation: Department of Emergency Medicine, University of Arizona, Tuscon, Arizona.
authors.forename: Kristina
authors.initials: K
authors.lastname: Waters
mesh_terms: D002982:Clinical Clerkship; D002983:Clinical Competence; D004504:Education, Medical, Undergraduate; D004521:Educational Measurement / Q000379:methods / Q000592:standards*; D004522:Educational Status; D004635:Emergency Medicine / Q000193:education*; D006801:Humans; D058996:Quality Improvement; D013997:Time Factors
keywords: assessment; clerkship; education; emergency medicine; evaluation; medical student; missing at random; recall bias; timing