Clinical supervisor evaluations during general surgery clerkships

Background: Clerkship performance is commonly evaluated by consultant surgeons who seldom supervise medical students directly. In contrast, surgical residents and interns frequently supervise students and provide essential teaching but are not tasked with evaluating them. Aim: To prospectively investigate and compare the accuracy of general surgery clerkship performance evaluations by clinical supervisors of differing seniorities. Method: Between September 2008 and May 2010, clinical supervisors of varying seniorities independently evaluated 57 fourth-year medical students using a multi-dimensional performance evaluation tool. Total evaluation grades and subtotal grades for clinical ability were correlated to the results of a validated surgical objective structured clinical examination (OSCE). Results: In this study, 85 clinical supervisors provided 427 student performance evaluations. Total evaluation grades awarded by consultant surgeons had weak correlation to student OSCE results (r = 0.27, p < 0.05) and associated subtotal grades for clinical ability had no correlation. In comparison, the equivalent sets of grades awarded by residents and interns had moderate correlations to OSCE results (r = 0.49 and r = 0.54, p < 0.01). Conclusions: Validity of clinical supervisor evaluations during general surgery clerkships vary according to assessor seniority. Including performance evaluation grades by surgical residents and interns may enhance the overall validity of this common clerkship evaluation tool and improve its summative and formative assessment value.

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