Rater Training in Medical Education: A Scoping Review

Abstract

There is an increasing focus in medical education on trainee evaluation. Often, reliability and other psychometric properties of evaluations fall below expected standards. Rater training, a process whereby raters undergo instruction on how to consistently evaluate trainees and produce reliable and accurate scores, has been suggested to improve rater performance within behavioral sciences. A scoping literature review was undertaken to examine the effect of rater training in medical education and address the question: "Does rater training improve performance attending physician evaluations of medical trainees?" Two independent reviewers searched PubMed®, MEDLINE®, EMBASE™, the Cochrane Library, CINAHL®, ERIC™, and PsycInfo® databases and identified all prospective studies examining the effect of rater training on physician evaluations of medical trainees. Consolidated Standards of Reporting Trials (CONSORT) and Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklists were used to assess quality. Fourteen prospective studies met the inclusion criteria. All had heterogeneity in design, type of rater training, and measured outcomes. Pooled analysis was not performed. Four studies examined rater training used to assess technical skills; none identified a positive effect. Ten studies assessed its use to evaluate non-technical skills: six demonstrated no effect, while four showed a positive effect. The overall quality of studies was poor to moderate. Rater training in medical education literature is heterogeneous, limited, and describes minimal improvement on the psychometric properties of trainee evaluations when implemented. Further research is required to assess rater training's efficacy in medical education.

Keywords: clinical assessment tools; medical education; non-technical skills; rater training; technical skills.