Evaluation of medical students during a clinical clerkship in internal medicine

During a three-month clinical clerkship in medicine 175 medical students were evaluated. A proficiency assessment process was developed which included preceptor evaluation of on-the-job performance as well as independent oral and written examinations. Analysis of data from this study disclosed small correlations among the three measurements of clinical competence. Ratings by preceptors, based on direct observations of students, also showed a large intrastudent variation. Although the individual clinical ratings had low reliability, averages taken over a period of time were more consistent. These data have importance not only in the assessment of the clinical competence of medical students but also in other areas of granting medical credentials and certification.