The GRADE Strategy of Evaluation
Potential Evaluation Pitfalls
The Halo Effect
When certain characteristics, either positive or negative, cause preceptors to overlook other important aspects of learner performance, e.g. an enthusiastic, caring learner with mediocre skills receiving high marks while a shy student with superior knowledge receives a lower grade.
"Oops": insufficient evidence
Describing a student's shortcomings by providing specific incidents and ways in which the student could have done better. At the end of the rotation it can be hard to remember the details of such incidents without a system for recording observations.
"But you never TOLD me that!"
Stating at the end of the rotation that the learner has fallen short of expectations when those expectations were not clearly stated during the rotations.
"But I NEED honors!"
Finding out on the final day of the rotation about the student's expectations and perceived needs for a particular grade or evaluation on the rotations.
"Uh-oh, should they pass?"
Realizing at the final evaluation that, despite significant efforts on the preceptor's part, the learner's performance has remained substandard throughout the rotation and that he or she should not pass. It is crucial to contact the school early in the rotation to get help.
The Lake Wobegon effect
Rating all students "above average," which does not help the school or the student accurately assess the student's strengths and weaknesses. The learner, future patients and the profession may suffer.
The GRADE Strategy for Evaluation
G-Get Ready
- Review course expectations and the evaluation form.
- Consider unique opportunities and challenges of your site.
- What are your expectations for the learner?
R-Review expectations with learner
- Meet early in the experience. Determine learner's knowledge and skill level.
- Review program goals, your goals and learner's goals.
- Describe the evaluation process.
A-Assess
- Observe.
- Record.
- Provide feedback regularly.
- Have learner self-assess.
D-Discuss assessment at midpoint
- Formal meeting.
- Learner and evaluator fill out form in advance.
- Compare evaluations together.
- Discuss differences and whether expectations are being met.
- Plan for the rest of the rotation.
E-End with a grade
- Schedule sufficient time.
- Complete evaluation in advance.
- Support your evaluation with examples.
- Highlight items that can be worked on in the future.
Langlois JP, Thach S. Evaluation using the GRADE strategy.
Family Medicine March 2001; 33(3):159-160).