SUMMATIVE EVALUATION AND GRADE DETERMINATION

1. Clinical Performance - 75% of Final Grade

Students will be evaluated by faculty based on progress towards the achievement of graduation competencies in the categories listed on the evaluation form, shown on the following page. Typically, one faculty member at each site is responsible for completing the form based on a compilation of their assessment and the assessment of others who worked with the student (primarily other faculty and residents, although input from clinic staff, patients and peers will be considered when pertinent). The Family Medicine component will be worth 2/3 of the clinical grade (i.e. 50% of the final grade) and the Internal Medicine component 1/3 (i.e. 25% of final grade).

2. Final Examination - 25% of Final Grade

The final examination is a combination of multiple-choice questions and performance based standardized patient encounters. The exam consists of 8 patient stations, each of which is followed by a computer station with multiple-choice questions. It focuses almost exclusively on the clinical presentations shown in Tables 1 and 2 above and requires students to:

a) Demonstrate the ability to perform a focused history and physical: Students will be asked to perform a focused history and/or physical exam on each standardized patient. As such, the exam provides objective evidence of each student's capability in the Data Gathering: History, and Data Gathering: Physical Exam Competencies. The standardized patient portion is worth ½ of the final exam points, with a fairly even split between history items and physical exam items.

b) Demonstrate an understanding of the differential diagnosis and management of common conditions from that differential: The computer stations include multiple choice questions that test each student's understanding of the differential diagnosis of presentations in Tables 1 and 2 and management of common conditions from that differential. Some questions also test problem solving ability and knowledge of basic science related to the presentations. As such, this portion of the exam assesses mastery of the following competencies: Core Discipline (Knowledge Base), Basic Science Foundation and Problem Solving. The multiple choice portion of the exam is worth ½ of the final exam points.

3. Determination of Final Grade

In the vast majority of cases, the final grade is derived directly from the components described above.
However, the Clerkship Director reserves the right to adjust a student's final grade in such a way that it best reflects the student's actual performance and their achievement of the clerkship competencies.