Clerkship  |  Introduction / General Information  |  Student Responsibilities & Evaluation Form Standards of Academic Conduct  |  Weekly Exam Instructions  |  Evaluation Guidelines and Grading Policy

Evaluation Guidelines and Grading Policy

Guidelines for evaluation of third year clerks are based upon the following principles:

1. Workup and care of assigned patients is a major responsibility of the third year student.Students are required to submit one H & P during the clerkship. If not adequate, a repeat H & P will be requested.
2. Clinical performance reflects attitudes, appearance, knowledge, application of information, problem solving skills, psychomotor skills, interrelationships with peers, paramedical personnel and faculty.
3. Performance evaluations are achieved by using multiple evaluators who have sufficient exposure with the third year student.
4. Written objective tests measure only a sampling of knowledge or recall at a given time, but provide useful information regarding performance on assigned study materials.
5. A 1-10 point grading system will be used for oral exams.
6. Seminars are mandatory and will take priority over all other activities. Attendance at seminars will be taken and absenteeism may be grounds for failure of the clerkship.

Student Seminars

Each student will deliver at least one patient focused student seminar. These will be scheduled after the second week of the rotation. Each student will select an interesting surgical case and give a formal case presentation including appropriate imaging studies. Following the case presentation the student will review the current surgical literature regarding the clinical problem addressed in the case. The student will provide faculty with a copy of a computer generated literature search on the clinical problem. The student seminars will be scheduled for 30 minutes per student.

Department of Surgery Evaluation Guidelines:

Students will be evaluated by these mechanisms during the rotation:

• Clinical evaluations by faculty (60%)
• Oral examination (10%)
• NBME Shelf Exam (30%)

Clinical Evaluations

Surgical faculty will evaluate students in writing at the end of the rotation. A student must achieve an average score of 70 or better to pass the rotation. Faculty will consider all aspects of clinical performance on their written evaluations.

Only those faculty who have had sufficient exposure to the student to adequately evaluate performance will complete a written evaluation.

Any student who fails their clinical evaluation must repeat the clerkship.

Oral Exam

A 30 minute oral exam will be given the last week of the rotation. The content of the exam will be drawn from your patient encounters. The exam is graded and accounts for 10% of the final grade. (see below)

NBME Shelf Exam

This is a commercially produced multiple choice exam that comprises 30% of the final grade. (see below) It is given on the last day of the rotation. Results are usually available 4 weeks after the examination is given.

• To ensure fairness in scoring over the course of the third year, scores for the NBME Shelf Exam will be normalized on a quarterly basis. This will offset the rise in scores normally observed in students taking the exam later in the year.
• The NBME adjusts the scores every 3 months, whereas our periods change every 2 months. Therefore, Periods 1 & 2 will be scored based on NBME's Quarter 1; Period 3 will be scored based on NBME's Quarter 2; Periods 4 & 5 will be scored based on NBME's Quarter 3; and Period 6 will be scored based on NBME's Quarter 4.
• A student who has delayed the start of the third year, or taken a leave of absence during the third year, will have their NBME score normalized to the actual number of periods completed at the time of the exam.
• Any student who scores below the 20th percentile must repeat the NBME shelf exam. If a student fails a second time they may be required to take the entire clerkship. 

Final Grade

To pass the rotation the students must:

• Achieve a total of 70 points by combining:
  • clinical evaluation (60%)
  • oral exam (10%)
  • NBME Shelf Exam (30%).

Points for each component are assigned as follows:

• A) Clinical Evaluation: Points = Average Clinical Score x .60
• B) Oral Exam: 1-10 point grading system
• C) NBME Shelf Exam (see table):

NBME Percentile Score	Points
above 90%	30
76 - 90%	27
61 - 75%	24
51 - 60%	21
34 - 50%	18
20 - 33%	15
Minimum Passing Score 20%
0 - 19%	0

The sum of A + B + C must be 70 or greater for a passing grade.

Remediation

If a student fails any portion of the required components and remediation is required, the student must contact the third year clerkship coordinator immediately and make the necessary arrangements for this remediation.

NBME Shelf Exam scores will be normalized to the actual number of third year periods completed at the time the retake NBME Shelf Exam is administered. Should the remediation occur after the end of the third year, the score will be normalized based on NBME's Quarter 4.

Honors

All evaluations and scores are forwarded to the Department Chair for review. Honors are awarded at the discretion of the Chair and are limited to the upper 20% of the class (not mandatory). In order for a student to achieve Honors they must score above the 90th percentile on the NBME shelf exam, score 8 or higher on the oral exam and be recommended for honors by the majority of their preceptors.

Learning Disability

If a student is aware of a disability which may influence his or her learning or clinical performance, it is the student's responsibility to notify the clerkship coordinator of this disability prior to the start of the clerkship. If the student fails to inform the clerkship coordinator of his or her disability, it will be assumed that the student has no disability and the clerkship will proceed as normal. All information will be kept confidential.

Clerkship Site

The clerkship must be completed at a designated third year site.

7/2006