Faculty sensitivity in detecting medical students' clinical competence

Abstract

The purpose of this study was to determine the sensitivity of subjective faculty evaluations (1) in detecting the levels of clinical competence exhibited by third-year medical students in a junior clerkship and (2) in correlating with objective measures of the students' performance. Forty-eight third-year medical students were evaluated during the course of a 10-week surgery clerkship. Each student was subjectively evaluated by four surgery faculty members and by a number of objective measures. Unlike the subjective evaluations, the objective testing clearly demonstrated students' deficiencies. None of the seven students identified as underachieving by the battery of objective tests was identified as deficient by any of the faculty evaluators. The subjective scores in this study did not correlate highly with objective tests of either knowledge or performance. Reliance on subjective clinical evaluations as the sole measure of clinical ability is clearly not warranted. To better define clinical competence in the medical student and resident population, we must de-emphasize subjective faculty evaluations and place greater importance on objective tests.