Improving Time to Completion of Medical Student Clerkship Evaluations

Medical student clinical clerkship evaluations provide feedback for growth and contribute to the clerkship grade and the student's residency application. Their importance is expected to increase even more with the recent change of the US Medical Licensing Examination Step 1 to a pass/fail designation. Timely completion of medical student clerkship evaluations is a problem. In this study, the authors aimed to increase the percentage of student evaluations completed by pediatric hospital medicine physicians within 14 days of assignment from 45% to 75% or greater using quality improvement (QI) methodology over a 1-year period (January through December 2021).

The evaluation program generated reports every 2 months. Control charts were used to analyze the data. Plan-Do-Study-Act cycles were performed. Interventions included education, baseline data knowledge, gamification, standardization, quarterly data updates, and weekly announcement of incomplete evaluations. Balancing measures included word count of narrative comments in the evaluation and percentage of clinical honors awarded.

Intervention implementation was associated with special cause variation of the primary outcome, with the average timely completion rate increasing from a baseline of 45% to 79%, which remained consistent during the 8-month sustainment period. Word count of narrative comments and percentage of honors designation had no special cause variation or shifts.

Using QI methods, timely completion of medical student clerkship evaluations was improved through several interventions, including weekly announcements of incomplete evaluations and gamification with quarterly recognition awards. QI methodology is an effective and practical way to improve timely completion of medical student clerkship evaluations.