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Can There Be a Single System for Peer Assessment of Professionalism among Medical Students? A Multi-Institutional Study

Arnold, Louise PhD; Shue, Carolyn K. PhD; Kalishman, Summers PhD; Prislin, Michael MD; Pohl, Charles MD; Pohl, Henry MD; Stern, David T. MD, PhD

Academic Medicine:
doi: 10.1097/ACM.0b013e3180555d4e

Purpose: Peer assessment is a valuable source of information about medical students’ professionalism. How best to facilitate peer assessment of students’ professional behavior remains to be answered, however. This report extends previous research through a multi-institutional study of students’ perspectives about system characteristics for peer assessment of professionalism. It examines whether students from different schools and year levels prefer different characteristics of peer assessment to assess each other candidly, or whether a single system can be designed. It then identifies the characteristics of the resulting preferred system(s).

Method: At the beginning of academic year 2004–2005, students (1,661 of 2,115; 78%) in years one through four at four schools replied to a survey about which peer assessment characteristics—related to, for example, who receives the assessment, its anonymity, and timing—would prevent or encourage their participation. Multivariate analysis of variance was used to detect differences among institutions and students from each year level.

Results: Students across year levels and schools generally agreed about the characteristics of peer assessment. They prefer a system that is 100% anonymous, provides immediate feedback, focuses on both unprofessional and professional behaviors, and uses peer assessment formatively while rewarding exemplary behavior and addressing serious repetitive professional lapses. The system, they emphasize, must be embedded in a supportive environment.

Conclusions: Students’ agreement about peer-assessment characteristics suggests that one system can be created to meet the majority of students’ preferences. Once implemented, the system should be monitored for student acceptability to maximize participation and to determine the formative and summative value of the process.

Author Information

Dr. Arnold is professor, Office of Medical Education and Research, and associate dean for medical education, University of Missouri–Kansas City School of Medicine, Kansas City, Missouri.

Dr. Shue is assistant professor, Department of Communication Studies at Ball State University. Formerly, she was assistant professor, Office of Medical Education and Research, University of Missouri–Kansas City School of Medicine, Kansas City, Missouri.

Dr. Kalishman is director, Office of Program Evaluation, Education, and Research, University of New Mexico School of Medicine, Albuquerque, New Mexico.

Dr. Prislin is professor of clinical family medicine and associate dean for student affairs, University of California–Irvine College of Medicine, Irvine, California.

Dr. Charles Pohl is professor of pediatrics and associate dean for student affairs, Jefferson Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania.

Dr. Henry Pohl is vice dean for academic administration, Julio A. Sosa MD chair in medical education, and director, Sosa Academy of Medical Sciences, Albany Medical College, Albany, New York.

Dr. Stern is associate professor of internal medicine and medical education, research associate professor, Center for Human Growth and Development, and director, Global REACH, University of Michigan Medical School and VA Ann Arbor Healthcare System, Ann Arbor, Michigan.

Please see the end of this article for information about the authors.

Correspondence should be addressed to Dr. Arnold, Professor and Associate Dean, University of Missouri–Kansas City School of Medicine, 2411 Holmes, Kansas City, MO 64108; telephone: (816) 235-1806; e-mail: (

© 2007 Association of American Medical Colleges