Midclerkship feedback in the surgical clerkship: the "Professionalism, Reporting, Interpreting, Managing, Educating,...

The Liaison Committee on Medical Education requires midclerkship formative (low stakes) feedback to students regarding their clinical skills. Student self-assessment is not commonly incorporated into this evaluation. We sought to determine the feasibility of collecting and comparing student self-assessment with that of their preceptors using an iPad application. These student self-ratings and preceptor ratings are jointly created and reviewed as part of a face-to-face midclerkship feedback session.

Using our iPad application for Professionalism, Reporting, Interpreting, Managing, Educating, and Procedural Skills ("PRIMES"), students answer 6 questions based on their self-assessment of performance at midclerkship. Each skill is rated on a 3-point scale (beginning, competent, and strong) with specific behavioral anchors. The faculty preceptors then complete the same PRIMES form during the face-to-face meeting. The application displays a comparison of the 2 sets of ratings, facilitating a discussion to determine individualized learning objectives for the second half of the clerkship.

A total of 209 student-preceptor pairs completed PRIMES ratings. On average, student-preceptor ratings were in agreement for 38% of the time. Agreement between students and preceptors was highest for Professionalism (70%) and lowest for Procedural Skills (22%). On average, 60% of student-preceptor ratings did not agree. Students rated themselves lower than preceptors 52% of the time, while only 8% of students rated themselves higher than their preceptors' ratings (this difference is significant at the P value <.05 level).

This study demonstrates the value of using the PRIMES framework to incorporate surgery clerkship students' self-assessment into formative face-to-face midclerkship feedback sessions with their preceptors with the goal to improve performance during the second half of the clerkship.