Everyone has a different approach to SLOEs, so it would be impossible to tell. I can tell you what I did for my five years as clerkship director. I would get all the evaluations, but specifically ask all residents and faculty to include areas of strength and areas for growth. If a single comment was made for a specific domain, it does not go on the final evaluation and does not go on the SLOE. If multiple assessors cited the same domain for growth over multiple shifts, then it goes on the final evaluation and SLOE. How that is worded also depended on the temporal spacing of the comments. If they were early-rotation comments and that domain was stronger by the end, then I would write something like "by the end of the rotation, throwaway987654321 had excellent differential diagnoses and management plans." The "read between the lines" is that they might not have been great at the beginning of the rotation. If that was still cited as an area for growth by the end of the rotation, that might instead read "throwaway987654321 continued to work on their differentials and management plans, and will be an area for growth in subsequent rotations." During our mid-rotation meeting I read all the cards verbatim and then discuss themes that might be emerging to address for subsequent shifts. I also tell the subinterns that if it is not on their final evaluation that they read, it is not on their SLOE - but not everyone does this. That means I am willing to put negative themes on their final evaluation, including feedback related to interpersonal skills, work ethic, etc. which others may not be willing to do. I felt like not putting it on their final evaluation that they can see felt like "torpedoing" them and did not want them blindsided.