The Required Written History and Physical is Alive, but Not Entirely Well, in Internal Medicine Clerkships

Background: Effective written communication is a core competency for medical students, but it is unclear whether or how this skill is evaluated in clinical clerkships. Purpose: This study identifies current requirements and practices regarding required written work during internal medicine clerkships. Methods: In 2010, Clerkship Directors of Internal Medicine (CDIM) surveyed its institutional members; one section asked questions about students' written work. Results were compared to similar, unpublished CDIM 2001 survey questions. Results: Requirements for student-written work were nearly universal (96% in 2001 and 100% in 2010). Only 23% used structured evaluation forms and 16% reported written work was weighted as a percentage of the final grade, although 72% of respondents reported that written work was "factored" into global ratings. Conclusions: Despite near universal requirements for student written work, structured evaluation was not commonly performed, raising concern about the validity of factoring these assessments into grades.