This study compares the traditional method (TM) of evaluating ward performance on the surgical clerkship with four structured, single-observer methods (SSOM) of evaluating the clinical skills demonstrated in patient workups, progress notes, physical examination, and technical performance. SSOM differed from TM in preciseness of evaluation criteria, training of evaluator, and amount of direct observation of clinical performance. SSOM appeared to be a more precise measurement instrument than TM and far more sensitive to the detection of clinical improvement. The study documents the significant contribution of a nurse-educator to the evaluation process, as this contribution correlates well with TM yet provides a unique and independent perspective. Finally, SSOM of evaluation correlated significantly with oral examination and the National Board of Medical Examiners (NBME) test results. Addition of SSOM to TM is recommended for clerkship evaluation of ward performance.
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