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Is it appropriate to use core clerkship grades in the selection of residents?

机译：在选择居民时是否宜使用核心业务级别？

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OBJECTIVE: This study challenges the appropriateness of using core clerkship grades for resident selection. The authors hypothesize that substantial variability occurred in the system of grading. DESIGN: In this retrospective cross-sectional study, variability in the grading systems for third-year core clinical clerkships were examined. From the Medical Student Performance Evaluation of applicants from U.S. medical schools for residency training in the authors' department in 2004 and 2005, the authors gathered the following variables: medical school, third-year core clerkship grading systems, and percentage of students in each grade category. Descriptive analyses were conducted and within institution variability across clerkship scores was analyzed using repeated measure analysis of variance (ANOVA) and t-test. SETTING: University teaching hospital. PARTICIPANTS: The survey covered 121 of 122 U.S. medical schools accredited by the AAMC/LCME. RESULTS: Grading systems used included: variations of Honors/Pass/Fail (H,P,F) system in 76 schools, letter grade systems in 22 schools, and other variants (eg, Outstanding, Advanced, and Proficient in 6 schools and Pass/Fail in 4 schools). Thirteen schools (10%) provided either no grading system or no interpretable system. Grading systems included were further defined into 2 scores in 6 schools, 3 in 34 schools, 4 in 38 schools, 5 in 23 schools, and more than 6 in 6 schools. For schools using a grading system containing 3 or more scores, the percentage of students given the highest grade was significantly less in Surgery (28%) compared with Family Medicine (34%) and Psychiatry (35%) (p = 0.001). CONCLUSIONS: Core clerkship grading systems and the percentage to which institutions grade students as having achieved the highest performance level vary greatly among U.S. medical schools. Within institutions, significant variability exists among clerkships in the percentage of the highest grade given, which makes interpersonal comparison based on core clerkship gradesdifficult and suggests that this method may not be a reliable indicator of performance.
机译：目的：这项研究挑战了使用核心业务级别来选择居民的适当性。作者假设在分级系统中发生了很大的变化。设计：在这项回顾性横断面研究中，检查了三年级核心临床工作人员的评分系统的变异性。根据2004年和2005年美国医学院校在作者部门进行居住培训的申请人的医学生表现评估，作者收集了以下变量：医学院，三年级核心业务评分系统以及每个年级的学生百分比类别。进行描述性分析，并使用重复测量方差分析（ANOVA）和t检验对整个业务评分范围内的机构差异进行分析。地点：大学教学医院。参与者：调查涵盖了AAMC / LCME认可的122所美国医学院中的121所。结果：使用的评分系统包括：76所学校的荣誉/通过/不及格（H，P，F）系统的变化，22所学校的字母评分系统以及其他变体（例如，6所学校的优秀，高级和精通和合格/ 4所学校未通过）。 13所学校（10％）没有提供评分系统或没有可解释的系统。包括在内的评分系统进一步定义为6所学校的2分，34所学校的3分，38所学校的4分，23所学校的5分和6所学校的6分以上。对于使用包含3分或3分以上评分系统的学校，与家庭医学（34％）和精神病学（35％）相比，外科手术（28％）成绩最高的学生比例显着减少（p = 0.001）。结论：美国各医学院校的核心文职人员评分系统和机构将学生评定为达到最高绩效水平的比例差异很大。在机构内部，书记员之间的最高职称百分比存在显着差异，这使得基于核心书记员职等的人际比较变得困难，这表明该方法可能不是可靠的绩效指标。

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