Midclerkship feedback in the surgical clerkship: the “Professionalism, Reporting, Interpreting, Managing, Educating, and Procedural Skills” application utilizing learner self-assessment

• Published in: The American journal of surgery Vol. 213; no. 2; pp. 212 - 216
• Main Authors: Hochberg, Mark, Berman, Russell, Ogilvie, Jennifer, Yingling, Sandra, Lee, Sabrina, Pusic, Martin, Pachter, H. Leon
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-02-2017; Elsevier Limited
• Subjects: Agreements; Clerkship feedback; Clinical Clerkship; Clinical Competence; Feedback; General Surgery - education; Health education; Humans; Learning; Medical education; Medical student evaluation; Medicine; Mobile Applications; New York; Physicians; Professionalism; Ratings & rankings; Self evaluation; Self-Assessment; Students; Students, Medical; Surgical clerkship; Medical education; Surgical clerkship; Clerkship feedback; Medical student evaluation
• DOI: 10.1016/j.amjsurg.2016.08.001
• EISSN: 1879-1883
• ISSN: 0002-9610

The Liaison Committee on Medical Education requires midclerkship formative (low stakes) feedback to students regarding their clinical skills. Student self-assessment is not commonly incorporated into this evaluation. We sought to determine the feasibility of collecting and comparing student self-assessment with that of their preceptors using an iPad application. These student self-ratings and preceptor ratings are jointly created and reviewed as part of a face-to-face midclerkship feedback session.
Using our iPad application for Professionalism, Reporting, Interpreting, Managing, Educating, and Procedural Skills (“PRIMES”), students answer 6 questions based on their self-assessment of performance at midclerkship. Each skill is rated on a 3-point scale (beginning, competent, and strong) with specific behavioral anchors. The faculty preceptors then complete the same PRIMES form during the face-to-face meeting. The application displays a comparison of the 2 sets of ratings, facilitating a discussion to determine individualized learning objectives for the second half of the clerkship.
A total of 209 student–preceptor pairs completed PRIMES ratings. On average, student–preceptor ratings were in agreement for 38% of the time. Agreement between students and preceptors was highest for Professionalism (70%) and lowest for Procedural Skills (22%). On average, 60% of student–preceptor ratings did not agree. Students rated themselves lower than preceptors 52% of the time, while only 8% of students rated themselves higher than their preceptors' ratings (this difference is significant at the P value <.05 level).
This study demonstrates the value of using the PRIMES framework to incorporate surgery clerkship students' self-assessment into formative face-to-face midclerkship feedback sessions with their preceptors with the goal to improve performance during the second half of the clerkship.