Assessment Policy

  

Overview/Rationale

Assessments are critically important for the development and evaluation of medical students’ competencies. Assessments not only measure students' performance but also identify areas where additional learning and support are required. Individualized feedback from assessments enables students to reflect on ways to continually improve their performance and enables educators to tailor educational interventions to meet the specific needs of each student, thereby fostering continuous improvement and personalized learning experiences. 

Accreditation Standards

LCME Accreditation Standard:

  • 9.5: Narrative Assessment
  • 9.7 Formative Assessment and Feedback 

Stakeholders

Compliance with this policy is mandatory for all VP&S Undergraduate Medical Education (UME) course directors, teaching faculty, resident and fellow physicians, and medical students. 

Formative Feedback is defined by the LCME as “Information communicated to a medical student in a timely manner that is intended to modify the student’s thinking or behavior in order to improve subsequent learning and performance in the medical curriculum." Examples of formative feedback opportunities include: quizzes, practice tests, study questions, formative OSCEs. 

Formative feedback opportunities are designed to provide feedback to students during the learning process. The primary goal of formative feedback opportunities is to support learning and improvement rather than contributing or informing to student evaluations or grades. These assessments are typically conducted throughout the learning period, allowing students to receive feedback on their progress continuously and giving them opportunities to improve their performance, thereby supporting students’ continuous development towards meeting course/clerkship objectives and the overall medical education program objectives. 

2. Lower-stakes assessments are designed to give students feedback to guide their learning process while also providing many snapshots of student performance over time, in order to measure student competency development, and will help in aggregate to inform final student performance evaluations. These include Work-place Based assessments, case write ups, and Team-Based Learning assessments.

Summative Assessments are used to evaluate students' overall performance and proficiency in a course, clerkship, or curriculum phase. The primary goal is to make judgments about students' achievement and assign grades or determine progression in Medical Education Program Objective domains. Summative assessments often take the form of comprehensive exams, standardized tests (e.g., USMLE Step exams), OSCEs, or end-of-clerkship evaluations. These assessments are more formal and carry higher stakes compared to lower stakes assessments. The focus of summative assessments is on determining whether students have achieved the intended learning outcomes and assessing their readiness for advancement. 

Narrative Assessment refers to written descriptions of a student’s progress and performance, including strengths, areas for improvement, and/or non-cognitive achievements. It may be used for formative feedback purposes to guide learning or for summative evaluation purposes. Narrative Assessment can come in the format of end-of-course OASIS Student Performance Evaluations, Workplace-Based Assessments, and written feedback on student assignments.  

Policy on Formative Feedback Opportunities and Mid-course/clerkship feedback 

 

Fundamentals Phase:  

All courses, four weeks or more than 30 hours of course contact time, will provide mid-course feedback on student performance in meeting course learning objectives. This may be accomplished through practice questions and self-assessments; formative OSCEs, individual feedback discussions between faculty or resident and student; release of individual results and class-wide performance data after knowledge-based assessments, with recommendations individualized for students at different levels of performance, and other mechanisms. 

Courses in the Fundamentals Phase shorter than four weeks or 30 hours of course contact time will provide mechanisms to give formative feedback to students so they may measure their progress in learning. This may be accomplished through study questions, practice assessments, workplace-based assessments (WBAs) and other mechanisms.  

NBME Customized Assessment Services (CAS) examinations are proctored examinations that VP&S students are required to take at the end of the first semester and start of third semester of the Fundamentals Phase. These are formative feedback opportunities that provide feedback to students on knowledge from fundamentals phase courses. They are meant to foster learning and do not contribute to course or semester grades. At the end of the Fundamentals Phase, all students must take the self-proctored NBME Comprehensive Basic Science Self-Assessment (CBSSA) as a formative self-assessment of foundational science topics.  

 

MCY Phase:  

For clerkships that are four weeks or longer, faculty or residents will provide formal feedback to students near the mid-point of the clerkship, with attested acknowledgment by the student. The purpose of mid-clerkship feedback is to review clinical performance and provide students with constructive, actionable feedback, and is not to inform students of what their final clerkship grade might be. The mid-clerkship feedback will include students’ areas of strength and provide suggestions on how students can improve or enhance their performance. Where necessary, faculty and administration should recommend the steps needed to strengthen performance and should assist students in the achievement of performance expectations. Mid-clerkship feedback must occur early enough during the clerkship to allow sufficient time for student growth and learning/ improvement.  

For students in the longitudinal Bassett program, mid-clerkship feedback must be provided at least once during the longitudinal integrated curriculum block for each clerkship.  

 

D&I Phase:   

For core sub-internships, Scholarly Projects, and electives that are four weeks or longer, faculty or residents will provide formal feedback to students at the mid-point of the sub-internship or course.  

Policy on Narrative Assessment 

VP&S ensures that a narrative description of a medical student’s performance is included as a component of the assessment in each required course and clerkship of the medical education program whenever teach-student interaction permits this form of assessment. Narrative feedback should be based on specific observations of the student’s behavior, as it relates to the associated medical education program objectives, including feedback related to the student’s strengths and specific areas for improvement. 

Fundamentals Phase:  

All courses in the Fundamentals phase are encouraged to provide students with narrative assessments as formative feedback. This may include feedback on assignments such as self-directed learning modules, individual and group projects, preceptor comments, and patient write-ups.  

Narrative assessments on student performance evaluations are required in the Fundamentals phase courses that include longitudinal faculty and student engagement in learning settings. This includes educational sessions when students work in small groups of 12 or less, meet at least three times, and are directly observed by a faculty member for at least 30 minutes or longer (taken together, or across all small group sessions). The narrative assessments will include faculty members’ or residents’ descriptions of individual student’s achievement of expected performance and will include faculty members’ observations of specific performance behaviors, including cognitive and non-cognitive behaviors.  

  • This includes the FCM Tutorials, FCM Seminars, and Psychiatric Medicine Courses. 

Major Clinical Year (MCY) and Differentiation & Integration (D&I) Phases.   

Lower-stakes narrative assessments are provided as part of required Workplace-Based Assessments in MCY clerkships, including direct observations of history and/or physical examination skills, and as part of formal mid-term feedback processes.  

Narrative assessments are required for MCY clerkships and electives that are two weeks or longer, core sub-internships, and Scholarly projects. The Narrative assessments are included as part of the summative student performance evaluation (SPE) submitted on OASIS.  

Narrative assessments are included as a component of the student’s final evaluation in each core MCY clerkship. The narrative contains summative feedback included in the Medical Student Performance Evaluation (MSPE) and formative feedback not used in the MSPE.  

Procedures / Responsibilities: 

  • This policy will be reviewed and revised as necessary, but at least every three years.  
  • Course and Clerkship Directors are responsible for ensuring medical students receive a Narrative Assessment as directed in the Procedures section of this policy. 
  • The Office of Curricular Affairs is responsible for ensuring course director/ faculty compliance with this policy.  
  • As part of the required MCY clerkship and core sub-internship student evaluations and as part of the Graduation Questionnaire, students are asked whether they received mid-clerkship feedback and ongoing informal feedback. These results are reviewed by clerkship directors and MCY/D&I curriculum subcommittee as part of their CQI process. Findings are reported to CEPC annually.