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MCG CLERKSHIP GRADES AND EVALUATION

2007-2008

Explanation of Clerkship Grading Policy

Site Performance

In many respects, site performance is synonymous with clinical performance. Each rotation site determines the manner in which the student’s time on the rotation is divided. It is expected that the site performance will proportionately reflect the types of activities in which the students are involved. In general, each week will count 10% of the final grade. Sometimes the experience is more integrated and viewed as an entire 3 or 6 weeks experience. In other cases, each week will be assessed as a separate entity.

GRADE DISTRIBUTION
The clerkship will adhere to the recommendations of the medical school in terms of   grade distribution. As you will note, an A on the clinical evaluation form should represent the top 20% of students.  When necessary, adjustments to the final grade will be made to approach this standard.

DETERMINATION OF CLINICAL PERFORMANCE
The Medical Student Clinical Performance Evaluation outlines the standards by which students will be graded on their clinical performance. Each rotation site uses this tool as the basis for clinical evaluations. As part of an overall evaluation, certain preceptors may outline specific components, such as formal presentations, which are required for the successful completion of the rotation. In such cases, presentations are considered   and assessed when completing the evaluation tool. No specific “percentage” is assigned.

During each phase of the rotation, students will receive evaluations from their preceptors and supervisors based upon this performance standard. The average score from all these subjective evaluations forms the basis for the clinical performance grade. Students who score less than an average of 70% for their final clinical performance grade will be required to remediate some or all of the clerkship.

            WHO PERFORMS YOUR CLINICAL EVALUATION

In general, attending physicians, preceptors and residents participate in your evaluation depending on your rotation site. At hospital based rotations at MCG, Atlanta Medical Center and Savannah, residents also participate in your education and evaluation. If you work with preceptors off-site, your preceptor(s) will be evaluating your clinical performance. 

OVERALL LETTER GRADE:

Final grades reported to the registrar per school policy are letters only. Grades are assigned for clerkship activities are numeric in order to provide a fair weighted average. The final numerical average is based on all components of the grade as outlined in the grading policy. The numerical average includes all examinations, points for core clinical activities and clinical evaluations. . Preceptors are encouraged to assign numerical grades   to avoid “conversion” confusion. Should a letter grade be returned, it must be converted to a numerical score in order to calculate the numerical average. The grading scale for converting clinical assessment letter grades to numerical grades is available through the clerkship office. It will only be used if a preceptor fails to assign a numerical score I a timely manner. Criterion referenced portions of grade are numerical and will be added to the other components of the grade before the final letter grade is assigned.

OUTSTANDING CLINICAL PERFORMANCE

A clinical grade above 97%   is considered significantly outstanding. Approximately one student per 6 week rotation would be expected to score this high (Upper 3 percent of peers). To be considered significantly outstanding, the clerkship office requires substantive documentary criteria in terms of narrative feedback. A comparable shelf exam score or performance on the mini-OSCE/oral exam would also serve as additional substantive documentation.

FINAL DETERMINATION OF CLINICAL GRADE

All grade information is reviewed and a final determination of grading is made by the clerkship director. The grading distribution scale is used as a guideline. However if more than 20%  of students   meet all substantive criteria for an A, the clerkship will grant more than 5 A’s per rotation. Likewise, if more than 3 % of students meet substantive criteria for significantly outstanding performance, the clerkship will waive the expected rate for affected students on any rotation in which this occurs.

2 students per year will be expected to score 99% or higher on their clinical performance evaluation (0.1%).

ADDITIONAL SITE PERFORMANCE EVALUATION

Each site will determine if additional criteria will be evaluated in addition to direct clinical performance. In some instances presentations, conferences and participation in other activities are used to determine a portion of your grade. Please discuss other expectations with your preceptor or site director in order to determine if they will use other criteria in determining your site performance. Some sites, such as MCG have clearly defined criteria. Other sites may base this upon the patient mix and other learning experiences available during your rotation.

Examinations

The table below outlines the examinations. A full explanation follows.

EXPLANATION OF TESTING

        MIDTERM:

ACCESSING MIDTERM TEST

The OBG5000 midterm exam is given by computer (WebCT) at each clinical teaching site during the fourth week of the rotation. Beginning at 8:30 am on the third Friday morning until 7:30 am on the fourth Friday, the testing site will be open on WebCT. 

WHAT IS COVERED IN THE MIDTERM

The questions are based on the knowledge content as outlined in the student curriculum guide. The examination consists of 100 multiple choice questions. This test is scored on a percent scale (0-100%). 

Because the midterm covers all objectives, no student is expected to have mastered all the material at the midterm. The midterm should give students guidance as to where to direct future study as well as help to assess mastery of those areas already covered.

                            EXPLANATION OF CRITERION REFERENCED TESTING

The midterm Examination is criterion referenced.  Criterion referenced means that as long as you meet the criteria, you will receive full credit for taking the exam.

REQUIREMENTS FOR RECEIVING COMPLETE CREDIT FOR MIDTERM

Completion of the test within the designated timeframe with a score of 50% or greater is necessary to receive the 2% of your final grade.

The test may be retaken as necessary to meet these criteria.

The highest score will be the score used to determine point eligibility. Failure to complete the test with a satisfactory score by the deadline results in 0 out of a possible 2% accrued toward the final grade.

If you have problems accessing the test, please contact the clerkship office at the earliest possible date. Waiting too long may limit your ability to achieve a score greater than 50%.    

SHELF EXAM

The National Board of Medical Examiners (NBME) Obstetrics and Gynecology Subject Examination is given on the final day of the clerkship.  The NBME Subject Test Score achieved on this exam is converted to a percent scale (0-100%). 

The Shelf Exam comprises 20% of the final grade.

SCORE CONVERSION

Student Performance on the NBME Obstetric and Gynecology Subject Exam is converted to a percentage score based on opinions provided by a national group of Obstetric and Gynecology clerkship directors. 

MINIMUM SCORES

Minimum Passing Score: 55

Minimum Honors Score:  83

REMEDIATION 

Students who score less than a 55 (70% on the converted scale) of the Obstetric and Gynecology NBME exam will need to remediate either the exam or the clerkship. Remediation is arranged through the Curriculum Office not the Clerkship.

GRADE ON FINAL TRANSCRIPT WHEN SHELF IS INITIALLY FAILED

If the student fails the initial attempt at the Shelf exam but remediates it and passes on the second attempt, the final grade will be reported in the format D/ B

The student receives the D for the initial component of the entire clerkship grade regardless of how high the clinical, miniOSCE or core clerkship grades actually were.

The second exam score will then be used to recalculate the second letter component of the grade. In this example, assume the student scores high enough that if it had been scored on the original shelf exam, the student would have made a B in the clerkship. The second component of the transcript grade will be reported on the transcript as D/ B.

 This is a school-wide policy.

Core Clerkship Activities

            GENERAL EXPLANATION

All students on the rotation participate in the core clerkship activities. These activities set a standard of expectation across sites for activities that are monitored and evaluated at the clerkship level.

Some of the activities are necessary to help monitor and meet the needs of students in achieving a minimum level of clinical exposure or to assure that students receive timely feedback. Other activities are designed to provide experience and documentation of aspects of the clerkship objectives.

 If the assignments are completed as directed in the clerkship manual, students achieve complete credit for them. Likewise if these criteria are not met or the assignments are incomplete, students will not receive credit.

The grid below outlines the assignments. Specific details of each assignment are available in the Clerkship Manual in the Chapter called Core Clerkship Activities.

Students are provided with a schedule of due dates on the back of green log card. In addition, the grid below indicates when assignments are due.

CORE CLERKSHIP ACTIVITIES GRID

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July 12, 2007