Assessing a Method to Limit Influence of Standardized Tests on Clerkship Grades

Abstract

Background: Grading committees give excessive weight to standardized-examination scores. Purpose: Understanding that biases are often ingrained in grading processes, we sought to assess the influence of a structured grading policy in limiting this effect. Methods: All 7 clerkship grading committees derived students’ clinical scores while blinded to examination scores. Scores were combined to yield a final rank order, which was used to derive grade cutoffs. Logit regression was performed to assess the contribution of clinical and examination scores to final grades. Results were compared to a similar analysis where committees were not blinded to examination scores. Results: In contrast to prior findings, grading committees consistently assigned greater weight to clinical-performance scores in assigning final grades when blinded to examination scores. Conclusions: Grading committees may be unaware of the extent to which they discount clinical assessments when they are at odds with the results of standardized examinations. This can be addressed with a procedure that blinds grading committees to examination scores.