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Purpose: The ability to create a concise summary statement can be assessed as a marker for clinical reasoning. The authors describe the development and preliminary validation of a rubric to assess such summary statements., Method: Between November 2011 and June 2014, four researchers independently coded 50 summary statements randomly selected from a large database of medical students' summary statements in virtual patient cases to each create an assessment rubric. Through an iterative process, they created a consensus assessment rubric and applied it to 60 additional summary statements. Cronbach alpha calculations determined the internal consistency of the rubric components, intraclass correlation coefficient (ICC) calculations determined the interrater agreement, and Spearman rank-order correlations determined the correlations between rubric components. Researchers' comments describing their individual rating approaches were analyzed using content analysis., Results: The final rubric included five components: factual accuracy, appropriate narrowing of the differential diagnosis, transformation of information, use of semantic qualifiers, and a global rating. Internal consistency was acceptable (Cronbach alpha 0.771). Interrater reliability for the entire rubric was acceptable (ICC 0.891; 95% confidence interval 0.859-0.917). Spearman calculations revealed a range of correlations across cases. Content analysis of the researchers' comments indicated differences in their application of the assessment rubric., Conclusions: This rubric has potential as a tool for feedback and assessment. Opportunities for future study include establishing interrater reliability with other raters and on different cases, designing training for raters to use the tool, and assessing how feedback using this rubric affects students' clinical reasoning skills.

This study assessed whether overall academic performance in undergraduate medical coursework can be predicted with reasonable accuracy by using grades from initial college-level courses rather than total premedical grade point averages (GPAs). Initial college grades from four areas, MCAT scores, and NBME I and II scores were recorded for students admitted to the University of Washington Medical School, for students admitted to other medical schools, and for students not admitted to any medical school. The results documented a high relationship between cumulative GPAs and initial grades, with differences found between those students admitted to medical school and those not admitted. The importance of this study is the documentation that little predictive utility is gained by waiting for overall college GPAs from medical school applicants. Initial GPAs are available 2 years earlier than overall GPAs and provide virtually the same information. Exploratory suggestions for medical school admission policies are made.