by Ellen Whiting, M.Ed., Faculty Development Coordinator

You have just precepted a medical student in your office and now you have the responsibility of evaluating her performance.  Facing you is an evaluation form with numerical ratings and space for comments.  Effective evaluators base their evaluations on their knowledge of the student and the evaluation criteria.  The following questions will help you complete an evaluation:

• What do you know about this student?
• What did the student do and say during interactions with you, patients and staff?
• What evidence do you have of the student's medical knowledge and clinical skills?
• Did you notice any change in the student's performance?
• What do you know about the evaluation criteria or standard of performance?

Numerical Ratings

Be clear about the stated minimum or acceptable levels of performance for each item. Base your evaluation decisions on these criteria, NOT your own expectations.  Below are sample criteria for performance levels on a five-point scale for clinical judgment and interpersonal skills:

Use criteria for "expected performance"(3) as the point of departure. Ask yourself, "Did this student perform better (or worse) than these expectations? Based on your observations, circle a higher or lower number respectively.  Resist thinking of the numbers as equitable to traditional grades, i.e., 1=E, 3=C, and 5=A. If no criteria are provided, base your ratings on your own expectations, but be sure to set reasonable expectations for the level of the individual learner.

Written Comments

Support numerical ratings with written descriptions of observed behavior - especially for low and high ratings. Students (and course directors) learn the most from your written comments.

1.Describe specific behavior and support it by specific incidents, whenever possible.

Worse: "You were quite dominating with some patients."

Better:"When advising Mr. Smith about exercise, you did not seem to be listening to what he was saying and he was forced to accept your argument."

2.Offer comments that are individual-referenced rather than comparative.

Worse: "You are the "most consistent performer of your group."

Better: "You were a productive member of the team by setting reasonable goals for yourself and for the group.

3.Identify areas of strength and frame your comments to encourage improvement.

Worse: "You are a super student. You pay attention and have a good attitude."

Better: "Your strengths are attending skills, empathy, and summarization. Your closure of the interview with Mrs. Smith was effective in managing an anxious patient."

Worse: "You were unable to obtain sufficient information from the patient."

Better: "I would like to see you polish your symptom pursuit. Set goals for consistently asking key questions during this part of the interview."

Common Rating Errors

Be conscious of a tendency to make any of these common rating errors:

• Error of leniency: rating students you know or like higher than the performance warrants

• Error of central tendency: displacing high or low ratings in the direction of what seems to be the average rating

• Halo effect: rating an item on the basis of your feelings about other characteristics of the student, e.g., a student’s appearance may influence your perception of his ability to conduct a physical examination.

• Logical error: giving similar ratings for traits that seem logically related to you, e.g., rating diagnostic ability and verbal ability the same when it is not justified.

• Proximity error: giving similar ratings on traits which are adjacent on the evaluation form

• Contrast error: rating a student in the opposite direction from your perception of your own ability of a given trait, e.g., if you have a high level of skill in a particular area, you may tend to rate others lower on this trait.