Improving Interrater Reliability of Medical Student Assessment by Clinical Supervisors.

Abstract

Clinical clerkships that rely on community preceptors as faculty and assessors are challenged by the variability in their assessments of student performance. This workshop was designed to improve the interrater reliability of preceptors' assessment of student performance. This workshop uses a series of videos showing standardized student interactions with standardized patients and a preceptor. The videos feature a borderline satisfactory student-patient encounter and a superior student encounter. For each case, there is a video of the student providing an oral presentation of the encounter to a preceptor. The concept of a plus/delta card is also presented. Participants are asked to note positive elements of the interactions and elements needing improvement on the plus/delta card while watching the videos. Next, participants share their assessment of the students with the group using an audience response system. Group discussion allows for consensus and leads to decreased variation in preceptor assessments of each student's performance. This workshop has been delivered to preceptors in our institution as a 1-hour workshop. Additionally, a version has been presented twice at national medical teaching conferences as a faculty development workshop, instructing faculty how to facilitate the workshop. Participant evaluations from the workshop show an increase in preceptors' awareness of specific student behaviors to observe as well as increased confidence with assessing more consistently across various student performances. Using videos with standardized patients, students, and preceptors demonstrating various qualities of performance is effective in improving precision in preceptors' assessment of students in clinical settings.