Setting standards to determine core clerkship grades in pediatrics

Area of Science:

• Medical Education
• Clinical Assessment
• Pediatrics

Background:

• Assigning final grades in clinical clerkships presents challenges for directors.
• Integrating subjective and objective data for summative grading is complex.
• Establishing precise pass/fail cut points requires robust methodology.

Purpose of the Study:

• To describe the experience of a standard-setting exercise in a pediatric clerkship.
• To establish defensible cut points for a 4-tiered grading system.
• To evaluate the impact of new grading standards on student performance distributions.

Main Methods:

• Utilized the Hofstee standard-setting approach with 8 faculty members.
• Conducted a survey to assess faculty attitudes towards the standard-setting process.
• Applied new cut points to a historical cohort of 116 medical students.

Main Results:

• The new grading schema indicated a potential increase in failing grades and a decrease in honors grades.
• Faculty found the Hofstee method easy to understand and fair.
• Faculty universally perceived grade inflation in the pediatric clerkship.

Conclusions:

• Practical standards can be set for medical student grading in pediatric clerkships using the Hofstee method.
• The Hofstee method facilitates the establishment of defensible cut points with multiple performance measures.
• This approach addresses challenges in summative grading within clinical clerkships.