Thursday, May 31, 2012

Writing Meaningful Evaluations


In medicine, especially in academic medicine, you write a lot of evaluations.

You evaluate each resident after each rotation you've worked with them on.
You evaluate each resident procedure you've supervised, each delivery, each injection.
Each medical student that rotates through.
Educational presentations and lectures - yep.
Summative evals for your resident advisees twice a year - check.
CME conferences, hospital conferences, online CME.

Sometimes these evaluations are of high quality and are useful to the student/ resident/presenter.  Sometimes they're not, and the student/resident/presenter misses out on the opportunity to make improvements and solidify what's working well.

So, here's The Singing Pen's Guide to Writing a Meaningful Evaluation:

1. You should have spent adequate time with the evaluatee* to write a fair and balanced evaluation.  If not, decline the eval.

2. Yes, circling the numbers and filling in the checkboxes is important.  But of equal importance are the comments that you write.  For medical students, the positive comments may end up in the student's Dean's letter; for residents, in letters of recommendation for future jobs.

3. Speaking of those circles and boxes - find out what the grading institution's definition of "average" or "competent" is...and resist the urge to grade inflate.  (Grade inflation is rampant in American medical schools.**)  One rule of thumb is that only the top 5-10% of your evaluatees should be given  "exceptional" or "honors" grades.

4. Not sure where to start with your comments?  Focus on the circle/checkbox attributes that you ranked either lower or higher than "average."  Provide specifics about why you felt the evaluatee was above or below what is expected.

5. If your evaluatee is deficient in some way, say so. (Medical schools, residencies, etc should be thoughtful about keeping this information confidential.)  This axiom should go without saying, but most medical evaluators do not like to give corrective or negative feedback.** Medical students should not arrive at residency, for example, with deficiencies that should have been addressed in medical school.

6. When you need to give corrective feedback, make sure it is objective (about observed behaviors or skills).  Again, sharing your specific observations is very helpful.

7. Balance your corrective feedback with positives that you observed.  An evaluatee early in his/her medical career may lack knowledge and experience but may still demonstrate compassion, eagerness, and team spirit, all of which deserve recognition.

8. If possible, give informal feedback in the middle of the rotation/year/etc to your evaluatee.  This gives the evaluatee the opportunity to improve shortcomings while building confidence regarding what he/she is doing well.  (If your evaluatee improves - or doesn't - that is also valuable info for your final eval.)  #5 issues should never be a surprise to evaluatees when the final evaluation arrives.

Remember, high quality evaluations provide specific feedback about behaviors or skills that the evaluatees are either doing well or should improve.  If it's the latter, provide specific advice regarding the steps needed to improve that skill.

*And, no, "evaluatee" is not a real word.  But it should be!

** http://www.stfm.org/fmhub/fm2008/may/paul333.pdf

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