Grading, Narrative Assessment, and Feedback Policy

Grading

Rational

Element 9.8 of the LCME standards for accreditation requires “a medical school has in place a system of fair and timely summative assessment of medical student achievement in each course and clerkship of the medical education program.  Final grades are available within six weeks of the end of a course or clerkship.

Policy Statement

Final grades for all courses and clerkships shall be available to students within 6 weeks of all course/clerkship requirements being completed.  

To ensure the timely submission of grades, the course/clerkship directors/coordinators will implement a post-course/clerkship completion escalation process:

  • Three weeks: The Department Chair will be formally notified of outstanding evaluations and asked to contact faculty delaying final grade determination. 
  • Four weeks: The Executive Director of Medical Education will be notified to take further action.  
  • Five weeks: Notify the Director of OAQI who will communicate with the Dean to request intervention. 

This structured escalation process is designed to ensure accountability at all levels and to maintain compliance with institutional and LCME expectations for grade submission.

Formative Feedback

Definition

Activities done early or throughout a course for the purposes of providing students with information to assist them in changing their approach to, or way of thinking of the content so that they may improve their understanding and/or skills before the conclusion of the course. 

Rational

Element 9.7 of the LCME standards for accreditation require “the medical school’s curricular governance committee ensures that each medical student is assessed and provided with formal formative feedback early enough during each required course or clerkship to allow sufficient time for remediation. Formal feedback occurs at least at the midpoint of the course or clerkship. A course or clerkship less than four weeks in length provides alternate means by which medical students can measure their progress in learning.”

Policy Statement

Formative assessments should not carry significant weight on final grades. Points for completion may be awarded. Evaluation of performance should inform the student of opportunities to improve if applicable.

All required courses/clerkships of four or more weeks must provide formal formative feedback to students at least once at the midpoint and maintain documentation of the completion of this requirement. 

Students in required clerkships must complete and document an observed history and physical (CEX form) and all required clinical experiences in the e-Passport System. Clerkships are responsible for verification and documentation of completion of these requirements. Students who do not complete these requirements will receive an Unsatisfactory (U) in the clerkship.

Narrative Assessment

Definition

As defined by the LCME in the DCI Glossary of Terms, narrative assessment is “written comments from faculty that assess student performance and achievement in meeting specific objectives of a course or clerkship, such as professionalism, clinical reasoning.”

Rational

Element 9.5 of the LCME standards for accreditation require “A medical school ensures that a narrative description of a medical student’s performance, including non-cognitive achievement, is included as a component of the assessment in each required course and clerkship of the medical education program whenever teacher-student interaction permits this form of assessment.”

Policy Statement

Courses in the preclinical years that contain small groups (≤12 people) with the same facilitator for at least three sessions should provide narrative assessments to all students on their performance in the small group setting.  Facilitators should address both the students’ strengths and areas for improvement based on a rubric or evaluation form provided by the course director.

The Foundations of Patient-Centered Care course must provide narrative assessments on all final evaluation forms.

Required courses/clerkships in the clinical years must document narrative assessment as part of the formative feedback given on mid-point evaluation forms. Narrative assessments must be included on all final evaluation forms for required courses/clerkships in the clinical years.

Revised by Phase 1: 11/26/2024
Revised by Phase 2: 12/10/2024
Passed by Curriculum Committee: 12/17/2024

Revised by Phase 2: 9/14/2021 
Passed by Curriculum Committee: 10/5/2021

Reviewed by Phase 2: 12/18/18 
Passed by Curriculum Committee: 12/21/18 
Policy Implementation: Course/Clerkship Directors 
Policy Contact: Senior Associate Dean for Student and Academic Affairs