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Background: Face-to-face formal evaluation sessions between clerkship directors and faculty can facilitate the collection of trainee performance data and provide frame-of-reference training for faculty., Objective: We hypothesized that ambulatory faculty who attended evaluation sessions at least once in an academic year (attendees) would use the Reporter-Interpreter-Manager/Educator (RIME) terminology more appropriately than faculty who did not attend evaluation sessions (non-attendees)., Design: Investigators conducted a retrospective cohort study using the narrative assessments of ambulatory internal medicine clerkship students during the 2008-2009 academic year., Participants: The study included assessments of 49 clerkship medical students, which comprised 293 individual teacher narratives., Main Measures: Single-teacher written and transcribed verbal comments about student performance were masked and reviewed by a panel of experts who, by consensus, (1) determined whether RIME was used, (2) counted the number of RIME utterances, and (3) assigned a grade based on the comments. Analysis included descriptive statistics and Pearson correlation coefficients., Key Results: The authors reviewed 293 individual teacher narratives regarding the performance of 49 students. Attendees explicitly used RIME more frequently than non-attendees (69.8 vs. 40.4 %; p < 0.0001). Grades recommended by attendees correlated more strongly with grades assigned by experts than grades recommended by non-attendees (r = 0.72; 95 % CI (0.65, 0.78) vs. 0.47; 95 % CI (0.26, 0.64); p = 0.005). Grade recommendations from individual attendees and non-attendees each correlated significantly with overall student clerkship clinical performance [r = 0.63; 95 % CI (0.54, 0.71) vs. 0.52 (0.36, 0.66), respectively], although the difference between the groups was not statistically significant (p = 0.21)., Conclusions: On an ambulatory clerkship, teachers who attended evaluation sessions used RIME terminology more frequently and provided more accurate grade recommendations than teachers who did not attend. Formal evaluation sessions may provide frame-of-reference training for the RIME framework, a method that improves the validity and reliability of workplace assessment.

Background: Residency work hour restrictions in 2003 changed medical student participation in overnight call., Purposes: The goal is to compare experiences, attitudes, and skills between medical students who did and did not participate in overnight call., Methods: Using a retrospective cohort design, all students at one medical school received a survey at the end of their 3rd-year internal medicine clerkship. Students at 3 clerkship sites were required to take overnight call, and students at 2 sites were not., Results: One hundred four of 167 (62%) students participated. Sixty-one of 104 (59%) took overnight call. Overnight call students reported improved team relationships and were able to evaluate more unstable "cross-cover" patients. Students who took overnight call were more likely to state it was worthwhile (58% vs. 34%; p = .034). Overnight call led to fatigue and the perception of interference with didactics., Conclusions: Overnight call within the internal medicine clerkship has positive and negative effects. With new residency work hour restrictions, schools may consider innovative ways to preserve the positive experiences while working to minimize fatigue and interference with learning.