The effectiveness of formal evaluation sessions during clinical clerkships in better identifying students with marginal funds of knowledge

Purpose. To compare evaluation methods for identifying third-year medical students whose funds of knowledge are marginal. Method. The written evaluation forms and comments from a formal evaluation session for 124 students in the inpatient medicine clerkship in 1992-93 at the Uniformed Services University of the Health Sciences F. Edward Hebert School of Medicine were reviewed. The written and verbal ratings of a student's general fund of knowledge were converted to similar five point categorical scales. For-each evaluation method, chi-square analysis was used to compare the students identified as having marginal funds of knowledge with those who scored less than or equal to 300 on the end-of-clerkship NBME subject examination. Results. Sixteen students scored less than or equal to 300 on the NBME subject examination. For the checklist descriptors, ratings of ''marginal'' identified three of these 16 students (a sensitivity of 19%). For the written comments on the evaluation form, ratings of ''marginal'' identified four of the 16 (a sensitivity of 25%). For the formal evaluation session, however, ratings of ''marginal'' identified seven of the 16 (a sensitivity of 44%). The specificity of a ''marginal'' rating was excellent (greater than or equal to 95%) for all three evaluation methods. Chi-square analysis was significant for each method (p less than or equal to .01). Conclusion. Although the ability of housestaff and faculty to identify students with weak funds of knowledge may be less than ideal, it may be improved by the routine use of a formal evaluation session. If done during the clerkship, this would allow for a specific plan of remediation to be designed with the instructors for the students at risk.