About the Book Table of Contents Sample Mistake #7 Sample Mistake #10

SAMPLE MISTAKE

Mistake # 7 - Underestimating the importance of the write-up and oral case presentation in your evaluation

Ideally, your evaluators will base their ratings on direct observation of your work. For example, the evaluation of your ability to take a history and physical exam should be based on direct observation. The literature has shown, however, that faculty members often don't observe students during a history and physical. How then do faculty rate students in these areas? In my opinion, if a faculty member has insufficient data to rate a student in a particular area due to lack of observation, he should refrain from evaluating a student in that area. In fact, most evaluation forms give the evaluator the option to mark "not observed."

While some will mark "not observed," others will proceed to rate you based on inferences made from their interactions with you during rounds. In particular, the quality of your oral case presentations and write-ups will be used to draw conclusions about your skill in taking a history and performing a physical exam. If your evaluator feels that your oral case presentation and write-up on a particular patient was complete, he may conclude that your history and physical exam was complete as well. This conclusion may or may not be true.

Did you know...

In a study of 322 students at the University of Virginia School of Medicine at the end of their third year, 51% reported never having a faculty member observe them while taking a history (Howley); 81% had never been observed performing a complete physical examination.

Did you know...

In one study, five of nine faculty participants rated a student's ability to take a history and physical exam from factors other than direct observation (Pulito). They wrote that "in the clinic setting, for example, if a student presents a patient to an attending and is verbally facile, succinctly describing a focused history and physical examination, the inference may be drawn that the student expeditiously obtained the relevant history and performed an appropriate physical examination."