What can go wrong with evaluation?

Here are some common pitfalls with evaluation.

1. Halo Effect: where one unrelated but outstanding characteristic has an effect on other aspects of evaluation.

For example, a learner who is very nice, friendly, outgoing, and well liked by staff, but clinically mediocre could get a very high evaluation. Likewise, quiet, reserved, introspective, but clinically excellent learners could receive a mediocre evaluation.

It is important to look beyond personality traits and consider the entire package of underlying knowledge, attitudes, skills, and performance when evaluating the learner.

2. Oops - Insufficient Evidence: This can lead to a difficult situation if you are trying to explain to a learner why you gave them a mediocre evaluation without specific information about what it is based on or what needs to be improved.

For example, Have you ever arrived at the end of the rotation with a sense that a student's performance was inadequate in some areas, but you were not able to recall the details of specific instances where this was demonstrated?

Having an ongoing system for assessing the student can help to alleviate this problem.

What information do you plan to collect regarding your student and how do you plan to collect it? (save this to your notebook)

3. "You never told me that!": You probably have certain standards of performance in mind, against which each student is compared. If the final evaluation is the first time these standards are discussed, you are likely to hear, "But you never told me that!"

For example, you may expect a learner to read about common clinical problems encountered during the rotation. You should mention this very early in the rotation and state that you will periodically ask the learner what they have learned from their reading. If you feel the student is not meeting the expectation in this area, specific and clear feedback should be given with specific behavioral examples. When you arrive at the final evaluation session, there should not be any surprises.

It is important to discuss criteria for evaluation as early as possible in the rotation and to provide ongoing feedback about what the student is doing well and where there is need for improvement.

4. "But I NEED honors!": Some students bring expectations for a particular grade or evaluation to the rotation. Although you are not directly involved with grading the student, your evaluation of the student plays a major role in determining the student's grade for the clerkship..

An early discussion of the learner's goals and expectations for the rotation will enable you to discuss your expectations with the student to enable him or her to meet these goals.

5. "Uh-Oh" Should they pass? : Although medical students tend to function very highly, it is possible that you could arrive at the end of a rotation with the realization that, your student's performance has been substandard. The final evaluation is not the best time to begin contemplating the issue of whether or not they should pass

If a learner appears marginal or problematic, it is crucial that you get help early. Contact the Clerkship Directors as early as possible so you can work with them to develop a plan to address the student's needs.

6. "Lake Wobegon" Effect : " ...and all our students are above average."

For the benefit of the learner, it is important that the evaluations be as accurate a reflection as possible of the student's abilities. Otherwise, the student is unable to benefit from the opportunities for growth and improvement that an accurate evaluation can provide.

These are just a few of the many potential pitfalls of evaluation. The good news is that most of these situations can be consistently avoided, making evaluation a useful educational tool rather than an uncomfortable chore.