1.0 Policy Purpose
The purpose of this policy is to establish the requirement for non-cognitive achievements, including Narrative Assessment, to make up part of a medical student’s assessment in required courses or clerkships, as appropriate.
2.0 To Whom the Policy Applies
This policy applies to faculty, staff, and students of The Warren Alpert Medical School of Brown University.
3.0 Policy Statement
Both cognitive (e.g., exam scores) and non-cognitive (e.g., professionalism) student achievements are used in the assessment of medical students. Narrative Assessment refers to written comments from faculty assessing student performance and achievement in meeting the specific objectives of a course or clerkship (e.g., professionalism or clinical reasoning) and is used when adequate student-faculty interaction occurs to appropriately assess the student’s knowledge and skills. Narrative Assessment is considered part of a student’s record and may be used in conjunction with other data to monitor student progress.
Narrative Assessment must meet the criteria herein to be a valuable component to students’ growth and progression. Narrative Assessment criteria for pre-clerkship and clerkship phases may vary due to its distinct nature and structure.
3.1 Pre-clerkship Phase Courses
Courses that meet the following criteria are required to use an end-of-course Student Performance Evaluation (SPE) with Narrative Assessment:
- there are five or more Small Groups with the same Small Group faculty member between the start and end date of the course; and
- the faculty to student ratio is no more than 1:10.
Every Small Group in pre-clerkship phase courses must meet these criteria in order to utilize SPEs with Narrative Assessment to measure student progression. Courses must assign SPEs consistently across Small Groups (i.e., courses cannot assign SPEs to one Small Group and not others).
3.2 Required Clerkships
All required clerkships must use SPEs with Narrative Assessments at the end of the clerkship. Clinical SPEs include ratings on all sub-Competencies and narrative assessments of the student’s overall strengths and improvement opportunities.
3.3 Recommendations
The Pre-clerkship Phase Subcommittee monitors the courses in the pre-clerkship curriculum that meet the criteria for Narrative Assessment. The Clerkship/Post-Clerkship Phase Subcommittee monitors the clerkships/courses in the clerkship/post-clerkship curriculum that meet the criteria for Narrative Assessment and may make any recommendations to the Medical Curriculum Committee (MCC) relating to Narrative Assessment or the overall course/clerkship. The MCC has final authority over the medical curriculum and may accept or reject any recommendations from its subcommittees. The appropriate curriculum director and course leader(s) will then be responsible for implementing MCC’s recommendations.
4.0 Definitions
For the purpose of this policy, the terms below have the following definitions:
- Medical Curriculum Committee (MCC):
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The curriculum committee that oversees the design, management, integration, evaluation, and enhancement of the medical education curriculum as a whole. MCC has final oversight over the medical education program.
- Medical School Competencies:
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The core competencies – from such domains as knowledge, skills, and behaviors -- which the Medical School has determined are essential for student success and to ensure graduates are competent, residency-ready physicians (e.g., medical knowledge, professionalism, communication skills). (Competencies may also be referred to as “medical education program objectives” by the wider medical education community.)
- Medical School Sub-Competencies:
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Specific, measurable milestones and performance indicators that define a Competency. Sub-Competencies provide the specific criteria used to assess a student’s proficiency in discrete behaviors, knowledge, and attributes of the overall Competency, and assess student progression from one phase to the next.
- Narrative Assessment:
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Written comments from faculty that assess student performance and achievement in meeting specific objectives of a course or clerkship, such as professionalism or clinical reasoning.
- Small Group:
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A collaborative instructional format where no more than 10 medical students in a group setting solve clinical cases or master specific skills, guided by a faculty member who facilitates discussion and guides clinical reasoning.
- Student Performance Evaluation (SPE):
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An evaluation tool that rates student performance on the Medical School’s core Competencies and Sub-Competencies in a course or clerkship. SPEs are completed by Small Group faculty and include ratings on the Medical School Sub-Competencies mapped to the respective course, and narrative assessments of the student’s overall strengths and opportunities for improvement.
5.0 Responsibilities
All individuals to whom this policy applies are responsible for becoming familiar with and following this policy. University supervisors and employees with student oversight duties are responsible for promoting the understanding of this policy and for taking appropriate steps to help ensure and enforce compliance with it.
Office of Medical Education: Will monitor and record the courses which appropriately use narrative assessment in compliance with this policy.
6.0 Consequences for Violating this Policy
Failure to comply with this and related policies is subject to disciplinary action, up to and including suspension without pay, or termination of employment or association with the University, in accordance with applicable (e.g., staff, faculty, student) disciplinary procedures.
7.0 Related Information
Brown University is a community in which individuals are encouraged to share concerns with University leadership. Additionally, Brown’s Anonymous Reporting Hotline allows anonymous and confidential reporting on matters of concern online or by phone (877-318-9184).
The following information complements and supplements this document. The information is intended to help explain this policy and is not an all-inclusive list of policies, procedures, laws and requirements.
7.1 Related Policies
7.2 Related Procedures
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7.3 Related Forms
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7.4 Frequently Asked Questions
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7.5 Other Related Information
- Relates to accreditation Standard 9, Element 5 mandated by the Liaison Committee on Medical Education (LCME), accrediting body for U.S. medical education programs.
Policy Owner and Contact(s)
Policy Owner: Dean of Medicine and Biological Sciences
Policy Approved by: Provost
Contact Information:
Policy History
Policy Issue Date:
Policy Effective Date:
Policy Update/Review Summary:
Updated language for clarity and compliance with University requirements.
Previous policy version(s) superseded by this policy:
- Narrative Assessment Policy (former Medical School Policy No. 09-05), Effective Date: April 19, 2019.