I applaud the efforts of Holmes et al (Pediatrics 2014;133:766–768) to provide guidance to clinicians asked to write narrative evaluations of medical students. As the authors correctly point out, thoughtful comments “provide meaningful feedback to the student about performance, and formulate strong statements for the Medical Student Performance Evaluation,” or MSPE. I have 1 concern related to the second function that remains to be addressed: how best to convey those comments to the end-users, program directors, and their residency selection committees.
This past year our institution received 934 applications for 16 residency positions, figures that I know are not unique. The average MSPE is ∼8 to 10 pages long. Most of the component clerkship evaluation reports contain quotations from the narrative comments written by the clinical evaluators. How to capture the essence of a student without overwhelming the capacity of those end-users is a challenge for a clerkship director like me who is charged with the task of submitting a course performance report for every student who completes the clerkship.
In recognition of that fact our institution has recently imposed a 1500-character limit for the narrative portion of the clerkship performance reports, the meat of the MSPE. It’s not unusual to receive an average of more than 10 evaluations with their comments per student. An amount of 1500 characters is not a lot of characters. It’s easy to edit out the “Nice job” and the “Will succeed at any...” but it is much more difficult to abbreviate the more valuable and thoughtful comments like the 2 examples presented in the article, 1 positive (742 characters) and 1 constructive (1027 characters), each comment representing one-half to two-thirds of the character allotment I would be allowed on any individual clerkship performance report.
As a member of our residency selection committee I welcome the effort to reduce the reading burden that comes with residency selection, but as a clerkship director I now find myself more in the role of an editor than a reporter in creating individual student clerkship performance reports. Although I recognize the value of thoughtful comments, I am concerned about the potential for being overwhelmed by an embarrassment of riches.
- Copyright © 2014 by the American Academy of Pediatrics