Assessment System – Narrative Assessment

Rationale

Narrative assessments reflect the learner’s performance at a personalized and individualized level, with resulting potential for learner self-reflection and self-improvement.

The BSOM is committed to ensuring that medical learners receive narrative feedback/assessment whenever feasible during all phases of the curriculum to promote a well-rounded view of the learner’s achievement.

Scope

This Standard Operating Procedure applies to all BSOM learners, faculty, course/clerkship directors, residents who participate in teaching and evaluating and other personnel working with these learners.

Definitions

Narrative Assessment: An instructor’s or observer’s written subjective assessment of a learner’s work or performance, including non-cognitive achievement.

Procedures for Implementation and Review

Foundational Curriculum

• Learners in required courses with longitudinal individual or small group experiences, laboratory experiences, and clinical experiences with the same facilitator for six or more sessions must receive narrative assessment. Narrative assessments are encouraged but not required when teaching methodologies are appropriate but there are less than six sessions of contact (examples: simulation, history and physical gathering, etc.).
• During the foundational curriculum learners will receive narrative assessment that includes one or more of the following aspects:
  • Application of foundational knowledge in case-based learning small group lessons.
  • Clinical skills, as observed during medical interviews, patient presentations, physical examinations and from medical documentation.
  • Teamwork skills, interpersonal communication and professionalism during small group activities, laboratory and medical simulation sessions.
  • Use of evidence, fluency of written communication and critical thinking during required experiences.

Core Clerkship/Advance Clerkship Curriculum

• Required clinical clerkships must include formative narrative assessment at the mid-rotation feedback session, and summative narrative assessment of overall performance (considering competency in patient care, medical knowledge, professionalism, interpersonal and communication skills, systems-based practice, and practice-based learning and improvement) on the final grade form.
• Narrative feedback must address both the learner’s strengths and specific areas for improvement.
• If a learner raises a concern about the narrative feedback, the course and/or clerkship director must discuss the concern(s) with the learner. Learners should refer to the Grade Appeal SOP.
• Course/clerkship directors will collaborate with the Office of Medical Education or the Office of Faculty Affairs and Leadership Development to ensure faculty are trained to provide narrative feedback.
• The Executive Curriculum Committee, its subcommittees, and the CQI Committee monitor the curriculum for opportunities that would allow narrative assessment. They ensure narrative assessments are distributed throughout the courses and clerkships.

Responsibilities

Office of Medical Education (OME)

Works collaboratively with course/clerkship directors to ensure faculty and residents are trained on how to provide narrative feedback.

Office of Faculty Development (OFD)

Works collaboratively with course/clerkship directors to ensure faculty and residents are trained on how to provide narrative feedback.

Executive Curriculum Committee (ECC) and its Subcommittee

Monitors the curriculum for opportunities that would allow narrative assessment and ensure narrative assessments are distributed throughout the courses and clerkships.

CQI Committee

Monitors the curriculum for opportunities that would allow narrative assessment and ensure narrative assessments are distributed throughout the courses and clerkships.

Schedule for Review

The policy is reviewed and may be revised by the Executive Curriculum Committee as necessary, but at least every three years.

Related Policies

Grade Appeals Process SOP

Applicable Laws, Regulations & Standards

9.0 Teaching, Supervision, Assessment, and Student and Patient Safety
9.5 Narrative Assessment