A Survey of Student Assessment in U.S. Medical Schools: The Balance of Breadth Versus Fidelity

Background: Faced with the challenge to develop models of assessment relevant to work of physicians, medical schools have broadened their assessment of medical student competency. Purpose: U.S. medical schools were surveyed to determine the extent to which student assessments have broadened beyond multiple-choice question (MCQ) examinations and preceptor ratings. Methods: A survey mailed to 126 accredited U.S. medical schools asked respondents to indicate the frequency with which a variety of assessment methods were used in each year of the curriculum. Results: Examinations dominated preclinical assessments. Year 3 relied heavily on faculty ratings, live observations, and MCQs. Preceptor ratings were used most in Year 4. Conclusions: A variety of competency assessments currently are used; MCQs remain a core assessment method. Year 3 had the greatest breadth of assessment strategies. The findings suggest that educators continue to be challenged to balance the breadth of competencies sampled with the fidelity of the assessment experience