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Where Is the Patient Voice in Clinical Clerkship Evaluations?

Abudu, Boya, MPH

doi: 10.1097/ACM.0000000000002615
Letters to the Editor

Fourth-year medical student, University of California, San Diego School of Medicine, La Jolla, California;; ORCID:

Disclosures: None reported.

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To the Editor:

The objective structured clinical examination (OSCE) is an evaluative tool that prepares students to apply two major clinical benchmarks: clinical competence and interpersonal communication.1 OSCEs involve simulated patient encounters that allow students to receive immediate feedback on interpersonal communication, advice that is important even after formal medical training. Patient feedback can highlight behaviors or skills that may be underemphasized or overlooked. In hindsight, the feedback I received during my OSCEs was one of the most valuable components of my medical education. Despite the value of the patient perspective, most medical school clerkship programs underutilize patient feedback in formal evaluations.2

Instead of asking patients for feedback on students’ humanistic qualities or patient communication skills, clinical preceptors often report their impressions of the patient perspective based on observed encounters with students. This approach prioritizes transient patient encounters over prolonged, rapport-building interactions between the student and patient, failing to capture the full patient care experience. Indeed, most practicing clinicians are aware that patient rapport is crucial to patient trust, quality of care, and clinical outcomes.

I would challenge medical schools to develop a curriculum that incorporates patient feedback into the clinical clerkship evaluation. It would be necessary to standardize feedback in a way that encourages interactions with a variety of patients without dissuading students from working with “difficult” cases, for fear of a poor evaluation. One possible solution would be to have a list of humanistic traits that patients, or their families if needed, could identify as representative of a student. Comments on such attributes, either at the end of or periodically throughout a clerkship, may provide insight into medical student performance that may be missed by clinical supervisors.

Patient feedback in clinical clerkship evaluations may play an important role in medical education by emphasizing interpersonal communication skills that are valuable to patients. Participation in clinical evaluations would empower patients to contribute to the training of the future clinicians who will be administering their care.

Boya Abudu, MPH

Fourth-year medical student, University of California, San Diego School of Medicine, La Jolla, California;; ORCID:

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1. Chima M, Dallaghan GB. Does student performance on preclinical OSCEs relate to clerkship grades? Med Educ Online. 2016;21:31724.
2. Lai MM, Roberts N, Martin J. Effectiveness of patient feedback as an educational intervention to improve medical student consultation (PTA Feedback Study): Study protocol for a randomized controlled trial. Trials. 2014;15:361.
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