Background

Washington University School of Medicine is committed to providing the highest quality education to medical students preparing to lead the future of health and medicine. Narrative assessment provides students with the critical guidance needed to improve performance. Acknowledging the importance of narrative assessment, Liaison Committee on Medical Education (LCME) element 9.5 requires that students receive narrative assessment as a component of assessment in each required course and clerkship of the medical education program whenever student/teacher interactions permit this form of assessment. Narrative assessment is defined as written comments from faculty that assess student performance and achievement in meeting specific objectives of a course or clerkship including knowledge, skills, behaviors, and attitudes including but not limited to professionalism and clinical reasoning to support students in meeting the Washington University School of Medicine Educational Program Objectives.

Policy

Narrative assessment is a required component of the assessment of each student in the Gateway Curriculum at Washington University School of Medicine. Narrative assessments of a medical student's performance will be provided when the following curricular conditions are met:

• Students work in small groups of 12 members or fewer and small groups of the same composition are observed longitudinally by the same faculty member for at least three sessions, with a ratio of one faculty member to one student team.

or

• The student is observed performing duties in the clinical setting.

Guidelines

In the Gateway Curriculum, small group teaching with 12 or fewer students with a longitudinal faculty member meeting with the same students over more than three sessions primarily occurs in the coaching small groups. While coaching does involve 1:1 review of the student assessment portfolio and general progress, these small groups are also where content related to ethics, health equity and justice, personal and professional identity, community engagement, and patient, student and clinical experiences are taught, discussed and debriefed. Based on these interactions, coaches regularly provide a narrative description of a medical student’s performance to the medical student, including knowledge, skills, behaviors, and attitudes. For central tracking, coaches attest bi-annually to giving this feedback to the students. Because of the unique teaching and coaching roles of these faculty/student interactions, all assessment done by and with coaches must be purely formative in nature. The content of the narrative assessments performed by the coaches are not collected centrally as they are strictly for formative purposes. We do track the attestation of completion centrally to ensure that all students receive this important narrative assessment.

Last approved on October 3, 2022

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