Assessment
(e.g.: student logs, SPs, shelf exam, clinical checklist, other). What follows is a draft outline of what may be used to evaluate students in medicine. It is our hope that the clerkship block directors will define a common template for evaluation including setting standards for an honors grade across clerkships.

• Clinical Grade 50%
• NBME Shelf 10%
• Standardized Patient 10%
• Other 20%
  (Participation at CMR conferences, transitions in care project, EBM project, reflective writing exercise, and participation in intra-session activities)

• Completion of midpoint feedback form on student logs, student performance
• Completion of observed history and physical examination: Each student is required to complete an observed history and physical, which includes a feedback form completed by the attending or resident supervisor. This session serves as formative feedback and is not part of the official grade.
• Completion of all required competencies as determined by the student log; students unable to complete the competencies will be required to complete online cases that demonstrate the core diagnosis and management issues covered in the competencies.
• Completion of project work (transitions in care, EBM and reflective writing)

Clinical Grade:
A standard clerkship evaluation form will be used. Again, it is our hope that the clerkship block directors will agree on a common form and on how honors and passing performances can be determined based on these evaluations. In the current formula, each attending, resident and intern on the team will complete an evaluation. The weighting of the evaluations is as follows:
Attending: 50%
Resident 33%
Intern 17%

The student will receive a clinical grade from each 4 week rotation and the 2 rotations will be averaged. Future versions may include 360 degree evaluations including evaluations from nursing, patients and peers.

NBME Shelf:
Students must achieve better than 2 standard deviations below the mean in order to pass the NBME Shelf Examination. Performance at the mean or better qualifies the student for honors.

Standardized Patient Assessment:
All students must perform at a passing level as determined by a standardized checklist in order to pass the clerkship. Students who perform at an exceptional level will be qualified for honors. Standardized patient evaluations will occur at the end of the clerkship and will consist of 2 cases.

Case 1: An elderly patient with COPD and pneumonia recently transferred from the ICU to the floor after an episode of recurrent respiratory failure. Students will be asked to assess the current status of the patient and discuss with him his desire for future aggressive measures. Students will be assessed on their ability to perform a follow up evaluation on a hospitalized patient, including interim history and focused physical examination. In addition, we will assess several of the other core competencies including communication, professionalism and understanding of threads material.

Case 2: A middle-aged, Hispanic, previously healthy man who is being evaluated for admission from the ED with fatigue, shortness of breath and bright red blood per rectum. Students will be assessed on history taking, physical examination, laboratory and x-ray interpretation and clinical and diagnostic reasoning. Again, communication and professionalism will be assessed through this measure as well.


A passing grade must be achieved on the clinical evaluation, NBME shelf exam, and Standardized Patient Assessment in order to pass the clerkship. In addition, students must complete all required activities. An IF grade is assigned if any portion of the clerkship requires remediation. Students who are at risk for failing the clinical portion will receive specific mid-course feedback.