EA-3303 Medical Student Narrative Assessment Policy

1.0       Purpose

The Liaison Committee on Medical Education (LCME) requires medical schools to maintain a defined process for providing narrative assessments in required courses and clerkships. These written evaluations give students timely feedback on their progress, strengths, and areas for improvement to promote professional growth. In alignment with these standards, VTCSOM fosters a professional community dedicated to developing patient-centered physicians who lead teams, improve systems, and deliver high quality care across diverse settings. Faculty monitor student progress toward competency-based outcomes and provide meaningful narrative assessments that support reflection, learning, and development, most effectively achieved in small group or individual learning environments.

2.0       Policy

Narrative assessment should be used when the learning experience and feedback opportunities align with the VTCSOM Educational Program Objectives and the school’s three mission-based professional identities, ensuring that feedback supports the holistic development of each student.  Narrative assessment may be formative (to guide improvement) or summative (to contribute to grading or evaluation).  Faculty should provide narrative feedback whenever a student’s performance or behavior can be individually observed.

Phase 1 (Pre-Clerkships)

Narrative assessment is required when:

• A student meets with the same faculty or facilitator for four or more sessions in a small group of 12 or fewer students (e.g., problem-based learning session)
• Narrative assessment is encouraged in other settings when the teaching method allows for individual observation (e.g., simulation, history and physical exams, clinical reasoning activities, coaching sessions, research presentations).

Phase 2-3 (Clerkships and Post-Clerkships)

All required clerkships, acting internships, and clinical electives must include:

• Formative narrative assessment on all assessment forms.
• Summative assessment of overall performance on the final grade form.
• Information available to all students in a timely manner through the learning management system or assessment platform.
• Narrative summative assessments from Phase 2-3 experiences (clerkships, electives, etc.) may be included in the Medical Student Performance Evaluation (MSPE).

3.0       Procedures

Appropriate and frequent formative feedback will be provided throughout the curriculum. Narrative description of a student’s performance, in addition to any numerical score or grade, must be included as part of the assessment in courses and clerkships where teacher-student interaction permits this form of assessment. Submission of narrative comments is centrally monitored to ensure they are consistently submitted. Course and clerkship directors and the Office of Educational Affairs ensure appropriate, structured evaluation forms are used (when applicable) to facilitate high-quality assessment (e.g., SPIRAL Harmonized Milestones Assessment). 

4.0       Definitions

• Narrative Assessment: Written faculty comments that assess a student’s performance and achievement in meeting specific course or clerkship objectives, such as professionalism and clinical reasoning (LCME Functions and Structure of a Medical School, Element 9.5). These comments should describe each learner’s strengths and identify areas for improvement.
• Formative Assessment/Feedback: Information provided to a medical student in a timely manner with the goal of guiding changes in thinking or behavior to enhance future learning and performance in the curriculum (LCME Functions and Structure of a Medical School, Element 9.7).
• Summative Assessment: Evaluation of student learning at the end of a defined instructional experience.

5.0       References

• VTCSOM Education Program Objectives 
• Formative Assessment and Feedback Policy EA-3304
• Medical Student Assessment Policy EA-3302
• Advancement and Graduation Policy EA-3301
• Office of Educational Affairs

6.0       Approval and Revisions

Approved by the Medical Curriculum Committee on November 20, 2025