Faculty Evaluations Correlate Poorly with Medical Student Examination Performance in a Fourth-Year Emergency Medicine Clerkship.
BACKGROUND
Clerkship directors routinely evaluate medical students using multiple modalities, including faculty assessment of clinical performance and written examinations. Both forms of evaluation often play a prominent role in final clerkship grade. The degree to which these modalities correlate in an emergency medicine (EM) clerkship is unclear.


OBJECTIVE
We sought to correlate faculty clinical evaluations with medical student performance on a written, standardized EM examination of medical knowledge.


METHODS
This is a retrospective study of fourth-year medical students in a 4-week EM elective at one academic medical center. EM faculty performed end of shift evaluations of students via a blinded online system using a 5-point Likert scale for 8 domains: data acquisition, data interpretation, medical knowledge base, professionalism, patient care and communication, initiative/reliability/dependability, procedural skills, and overall evaluation. All students completed the National EM M4 Examination in EM. Means, medians, and standard deviations for end of shift evaluation scores were calculated, and correlations with examination scores were assessed using a Spearman's rank correlation coefficient.


RESULTS
Thirty-nine medical students with 224 discrete faculty evaluations were included. The median number of evaluations completed per student was 6. The mean score (±SD) on the examination was 78.6% ± 6.1%. The examination score correlated poorly with faculty evaluations across all 8 domains (ρ 0.074-0.316).


CONCLUSIONS
Faculty evaluations of medical students across multiple domains of competency correlate poorly with written examination performance during an EM clerkship. Educators need to consider the limitations of examination score in assessing students' ability to provide quality patient clinical care.
Department of Emergency Medicine, Harvard Medical School, Boston, Massachusetts; Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
Nicole M
NM
Dubosh
Department of Emergency Medicine, Maricopa Medical Center, Phoenix, Arizona.
Jonathan
J
Fisher
Department of Emergency Medicine, Harvard Medical School, Boston, Massachusetts; Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
Jason
J
Lewis
Department of Emergency Medicine, Harvard Medical School, Boston, Massachusetts; Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
Edward A
EA
Ullman
D000073978:Academic Performance / Q000592:standards*; D002982:Clinical Clerkship; D002983:Clinical Competence / Q000592:standards; D004504:Education, Medical, Undergraduate / Q000379:methods / Q000592:standards; D004521:Educational Measurement / Q000379:methods / Q000592:standards*; D004635:Emergency Medicine / Q000193:education*; D005180:Faculty, Medical / Q000592:standards / Q000706:statistics & numerical data; D006801:Humans; D011787:Quality of Health Care; D015203:Reproducibility of Results; D012189:Retrospective Studies; D013337:Students, Medical / Q000523:psychology / Q000706:statistics & numerical data*; D058013:Test Taking Skills / Q000523:psychology / Q000592:standards*; D000078329:Workforce
evaluation; medical student clerkships; written examinations