As a new faculty, one of the first challenges that I encountered was completing evaluation forms for medical students and residents. In our department, a Daily Evaluation Card (DEC) is to be completed at the end of every shift for each learner. These DEC’s are then collated by the program directors to yield a summative final rotation evaluation.
What I wondered was: how can I best use these DEC’s to help learners progress as medical professionals and at the same time provide critical information for the PD’s?
Fortunately, I stumbled upon a 2008 Medical Education paper called “Assessing the quality of supervisors’ completed clinical evaluation reports” by Dr. Nancy Dudek (University of Ottawa). This article was what I was looking for. Although this article was intended to evaluate the quality of the summative evaluation, the principles remain applicable to the DEC’s.
- End-of-rotation evaluations usually consist of a checklist/rating scale and written comments. These forms have questionable reliability and validity.
- End-of-rotation evaluations remain a valuable resource when trying to assess what a trainees “actually do” versus what they “can do” (eg. on an exam).
- The study attempted to determine the features of a high-quality evaluation and to develop an instrument to assess its quality.
Using brainstorming and a modified Delphi consensus technique, a focus group developed a Completed Clinical Evaluation Report Rating (CCERR) form. This form was then tested nationally and revised to yield a tool which evaluated 9-items each on a 5-point scale. This CCERR tool was found to be a reliable and valid means to differentiate superior from average from poor end-of-rotation evaluations.
The 9-item CCERR checklist
How would your own Daily Evaluation Card evaluations fare? Use a 5-point scale (1 = not at all, 3 = acceptable, 5 = exemplary).
- Checklist/ numeric ratings show sufficient variability to allow identification of relative strengths and weaknesses of the trainee.
- Comments are balanced providing both strengths and areas for improvement.
- The trainee’s response to feedback and/or remediation during the rotation is described in the comments.
- Comments justify the ratings provided.
- Clearly explained examples of strengths using specific descriptions (not generalizations) are provided in the comments.
- Clearly explained examples of weaknesses using specific descriptions (not generalizations) are provided in the comments.
- Concrete recommendations for the trainee to attain a higher level of performance are provided.
- Comments are provided in a supportive manner.
- Overall, this end-of-rotation evaluation provides enough detail for an independent reviewer to clearly understand the trainee’s performance on the rotation.