College of Medicine:Narrative Assessment Policy

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LCME Element 9.5 states that "A medical school ensures that a narrative description of a medical student’s performance, including his or her 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." These provide essential feedback to students as they develop their cognitive, behavioral, clinical, and communication skills.

Narrative comments are written descriptions of student performance and/or behavior, usually at least 2-3 sentences in length, that are intended to provide students with additional information about their strengths and opportunities for improvement beyond numeric data. These are defined per LCME Element 9.5 as follows:

  • Formative (“feedback”)—comments provided to students intended for formative purposes only and not included as a part of a graded assessment
  • Summative (“assessment”)—comments that are part of a graded assessment

Provision of narrative comments should occur in all settings in which a student is able to independently demonstrate a performance or behavior and can be individually observed by a faculty member, resident, or teaching assistant for an adequate period of time.

Phase 1

All Phase 1 blocks must incorporate at least one activity that provides students with narrative comments.  Activities in which narrative feedback is required include:

  • Communication small groups with end of semester summary comments
  • Anatomy laboratory sessions
  • Block OSCE standardized patient comments
  • Longitudinal Clinical Experience (at the end of each semester)

Activities in which narrative assessment is required include:

  • Self-directed learning activities
  • Health system science essays
  • Block OSCE comments by evaluators
  • Comprehensive Clinical Skills Examination- Part 1

Phase 2/3

Activities in which narrative assessment is required include:

  • Mid-rotation and final clerkship evaluations within Phase 2
  • Each clinical/sub-internship experience in Phase 3 (not all rotations)
  • Each clerkship specific OSCE
  • Comprehensive Clinical Skills Examination- Part 2

In addition to the above, faculty and residents are encouraged to include narrative feedback when documenting students’ behaviors related to attributes using established rubrics.

Approved by the Curriculum Committee: May 28, 2024