Relationship Between Institutional Standardized Letter of Evaluation Global Assessment Ranking Practices, Interviewing Practices, and Medical Student Outcomes

Pelletier-Bui, Alexis; Meter, Michael Van; Pasirstein, Michael; Jones, Christopher; Rimple, Diane

doi:10.1002/aet2.10079

Cited by 8 publications

(15 citation statements)

References 5 publications

(7 reference statements)

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“…They may be faced with the struggle between objectively assessing students and wanting them to match. Program and clerkship directors likely acknowledge the impact that placing a candidate into the lower categories may have on their competitiveness for a residency position . With only 4 weeks to observe a student, it may also be difficult to neatly place them into a quantile.…”

Section: Discussionmentioning

confidence: 99%

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A Retrospective Cohort Study of the Effect of Home Institution on Emergency Medicine Standardized Letters of Evaluation

Boysen‐Osborn

Andrusaitis

Clark

et al. 2019

AEM Education and Training

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Background: The standardized letter of evaluation (SLOE) was developed to make letters of recommendation in emergency medicine (EM) more objective and discerning. Typically, students obtain one SLOE from a home EM rotation and at least one more SLOE from an away clerkship. It is unclear if students perform better on their home or away EM rotations.Objective: The purpose of this study was to determine if students perform better on the group SLOE at their home institution compared to an away institution. Methods:The authors performed a retrospective application review of all allopathic applicants to an urban, academic EM residency program. The authors calculated a composite score (CS) for each group SLOE, using the global assessment scores for comparative rank and rank list position. A lower CS indicates better performance. The authors compared mean CS for students' first home rotations with first away rotations. For students in the study who had a third (second away or second home site) SLOE available, the authors compared mean CS on the students' first SLOEs with mean CS on the students' third SLOEs.Results: A total of 624 records were included in the primary analysis. There was a small, but significant difference between mean CS for students' home rotations when compared to away rotations (4.67 vs. 4.85, p = 0.024). Students performed better on their home rotations. Students who had three SLOEs available performed worse on their third rotation (first = 4.40, second = 4.63, third = 4.77, p = 0.012 for first vs. third). For all available SLOEs, more than 50% of students fell into the top 10% or top one-third categories.Conclusion: Students perform slightly better on their home EM rotations. Students' mean SLOE CS is slightly worse for a third rotation when compared to a first rotation.

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Section: Discussionmentioning

confidence: 99%

“…Despite efforts to maintain objectivity, SLOE authors may inflate scores . Many SLOE authors do not adhere strictly to quantile categories because they are concerned about negatively impacting a student's ability to match . It is unclear whether students receive higher scores on the group SLOEs from home rotations versus away rotations.…”

mentioning

confidence: 99%

A Retrospective Cohort Study of the Effect of Home Institution on Emergency Medicine Standardized Letters of Evaluation

Boysen‐Osborn

Andrusaitis

Clark

et al. 2019

AEM Education and Training

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“… 1 , 5 , 6 The SLOE gives readers objective data by ranking students in tertiles in seven categories of “Qualifications for EM.” Additionally students are ranked as the top 10%, top third, middle third, or bottom third for a global assessment and estimated position on the rank list. 7 …”

Section: Introductionmentioning

confidence: 99%

“…Li et al evaluated gender biases in SLOEs and found that the narrative portions were, “relatively free of gender bias.” 8 A study from Pelletier-Bui et al surveyed SLOE writers and found that most SLOE writers did not strictly adhere to the SLOE guidelines citing a fear that a weak evaluation could prevent an applicant from obtaining a position as an EM resident. 7 Girzadas et al studied the precursor to the SLOE, the standardized letter of recommendation, and found that female letter writers were twice as likely to give the highest ranking to female applicants giving a basis for some ingroup bias. 9 Although the effect of home institution on a SLOE was not studied until 2019, 10 Program directors have long held slight preference for a SLOE from an away rotation over a SLOE from their home rotation.…”

Section: Introductionmentioning

confidence: 99%

A Comparison of Standardized Letters of Evaluation for Emergency Medicine Residency Applicants

Wilson¹,

Laoteppitaks²,

Chandra³

2021

WJEM

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“…SLOE writers report grade inflation to minimize the risk of applicants not matching, with nearly one-quarter of SLOE writers acknowledging that they “sometimes” or “frequently” inflate GA rankings. 6 , 7 Despite this, the actual impact of a lower-third GA ranking in the SLOE on ultimate match outcome is unknown. Our study is the first, to our knowledge, to directly evaluate the impact of a lower-third GA ranking upon successful match rates in EM using actual NRMP outcomes data.…”

mentioning

confidence: 99%

Lower-Third SLOE Rankings Impede, But Do Not Prevent, A Match in Emergency Medicine Residency Training

Hansroth

Davis

Quedado

et al. 2020

Journal of Medical Education and Curricular Development

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Objective: Emergency medicine program directors (PD) value the standardized letter of evaluation (SLOE) as the most important aspect of a residency application when making both invitation and ranking decisions. This study aims to determine whether the presence of any lower-third in either SLOE global assessment (GA) question impacted the ability of an applicant to match into EM. We hypothesized that any lower-third ranking would be associated with increased odds of not matching into EM. Methods: We conducted a retrospective cohort study evaluating allopathic applicants from medical schools in the United States (US allopathic applicants) to a single EM residency program during the 2018/2019 match cycles. GA SLOE rankings from all applications were tabulated and compared to the applicant’s National Resident Matching Program (NRMP) match outcome. Comparative analyses were conducted between SLOE groupings and odds ratios (OR) were calculated. Results: A total of 2,017 SLOEs from 781 US allopathic applicants were analyzed during the study period. Of the total, 277 (35%) applicants in our sample had any lower-third GA ranking, which significantly decreased an applicant’s odds of matching in EM by 79% (OR 0.21, 95% CI, 0.12-0.34). Having more than one lower-third GA ranking did not further statistically decrease the odds of a successful EM match (OR 0.60, 95% CI 0.31-1.17). As a secondary finding of the study, results demonstrate that those applicants having no lower-third GA rankings had a nearly 5 times increased odds of an EM match (OR 4.84, 95% CI, 2.91-8.03). Conclusion: Having any lower-third GA ranking significantly reduced an applicant’s chances of matching into an EM program. Faculty advisors should be aware of the increased risk of not matching for any applicant with any lower-third GA ranking and advise students appropriately, while maintaining the integrity of the SLOE and not divulging the confidential information contained within.

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Relationship Between Institutional Standardized Letter of Evaluation Global Assessment Ranking Practices, Interviewing Practices, and Medical Student Outcomes

Abstract: Background: Emergency medicine (EM) program directors rely largely on the standardized letter of evaluation

Cited by 8 publications

References 5 publications

A Retrospective Cohort Study of the Effect of Home Institution on Emergency Medicine Standardized Letters of Evaluation

A Retrospective Cohort Study of the Effect of Home Institution on Emergency Medicine Standardized Letters of Evaluation

A Comparison of Standardized Letters of Evaluation for Emergency Medicine Residency Applicants

Lower-Third SLOE Rankings Impede, But Do Not Prevent, A Match in Emergency Medicine Residency Training

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