Normative vs. criterion based grading

Discussion in 'Medical Students - MD' started by bkflaneur, Mar 28, 2007.

  1. bkflaneur

    bkflaneur Senior Member
    5+ Year Member

    Oct 18, 2005
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    Medical Student
    I'm curious to know what other people's experiences have been with different grading policies in med school. I'm on my school's curriculum committee, and we're going to be discussing this issue soon.

    I'm particularly interested in how schools grade students during the clinical years. Anyone know if most schools use a normative system that awards honors to the top 10-20% or if it's more common to use a criterion-based system that gives a top grade to anyone who makes the cut? I can see arguments for both methods. My main concerns are to create a policy that's fair, student friendly, and that doesn't encourage competition between students. My main worry with a normative system is that it puts students in direct competion with each other on the rotation. I realize that some competition's inevitable - it's the nature of the beast. But it would suck to feel like you're in direct competition with the other student on the floor with you - I can imagine that leading to some nasty situations. Our school has 5-8 teaching sites for each rotation. So in reality, you wouldn't be with your fellow students on a daily basis. Maybe this would avoid the feeling of constant comparison and competition. But there's also the inevitable randomness of easy/hard grading.

    The current proposal is for our school to adapt a normative grading policy. My gut is against it, but not sure yet.

    Any thoughts? Thanks.
  2. Samoa

    Physician Pharmacist 10+ Year Member

    Feb 14, 2002
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    Criterion-based is more appropriate to this level of training, IMHO. If your school is having problems with people not being on par with graduates of other schools, then what needs to happen is a change in the criteria, not the implementation of normative grading.

    I mean, really, is the point to teach all the students to be good doctors, or is it the goal to foster competition between them? Do you want to give honors to the top 10%, no matter how mediocre on an absolute scale they are, or would you rather give honors to everyone who significantly exceeds the standard, even if it's half the class?

    My gut feeling is that it shouldn't be a negative thing for 50% of your students to be outstanding. But if they're not, when compared to students at other schools, then it's the standards themselves that are too low, and not the fact that your school uses a criterion-based grading system.

    Normative grading is only appropriate when the assumption is that not all the students are capable of becoming competent physicians (contrary to the stated assumption of most US med schools), and when the goal is to eliminate those who are not. If everyone is expected to succeed, normative grading is inappropriate.
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  3. Tired Pigeon

    10+ Year Member

    Jan 27, 2007
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    Resident [Any Field]
    I think normative grading at this point is just undermining the sense of cooperation among my classmates. We all had to meet certain standards to be here, so presumably we're all 'qualified' and don't need to be weeded out. So what's the point of the normative system? If clear criteria for excellence/honors are laid out and 80% of my class exceeds these standards, why should they not all be commended for this?

    And yes, I'm pissed about getting a 96.7% in a preclinical class and NOT getting an honors designation due to normative grading. Wouldn't you be pissed too?

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