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Evaluation Disparity and Implicit Bias in Medical Student Grading: Findings from Evaluator Focus Groups

Purpose: To perform a needs assessment of medical student evaluators to uncover reasons for evaluation disparity in order to work towards improving the quality, consistency, and accuracy of OB/GYN clerkship evaluations.

Background: Accurate evaluation of medical student clinical clerkship performance is challenging. Scale-based student ratings often do not correlate to comments provided. Additionally, there can be a wide variance of scores for the same student by different evaluators. Information regarding differing grading systems is available, but there is a lack of guidance around inter-rater reliability and implicit bias.

Methods: From May - July 2019, we performed three resident and faculty focus groups. We began the session discussing evaluation form reliability and current behaviorally anchored rating scales, same student evaluation inconsistencies demonstrated between evaluators, accuracy, and potential evaluator bias. Qualitative analysis utilizing two reviewers was used to identify themes.

Results: Overall, participants expressed a need for more formal student evaluation information and instruction. Other themes were requests for education and information regarding the evaluation forms and student grading, an admission of variation between ‘hard’ and ‘easy’ graders, and implicit bias in student evaluation, particularly regarding perceived specialty choice.

Discussions: Evaluators felt a need to better understand how evaluations contributed to student rotation grades and were interested in improving the quality, consistency, and accuracy of evaluations. Time with students directly influences the accuracy of objective evaluations. Implicit bias around one’s own ‘grading scale’, and around student specialty selection, can influence student evaluations.

Topics: CREOG & APGO Annual Meeting, 2020, Student, Resident, Faculty, Clerkship Director, Clerkship Coordinator, Professionalism, Interpersonal & Communication Skills, UME, Assessment,