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

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Abstract
Faced with the challenge to develop models of assessment relevant to work of physicians, medical schools have broadened their assessment of medical student competency. 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. 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. Examinations dominated preclinical assessments. Year 3 relied heavily on faculty ratings, live observations, and MCQs. Preceptor ratings were used most in year 4. 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.