Analysis of pre-clinical student narratives - progress in assessment of ACGME competencies

Pre-clinical exposure to patients provides opportunities for medical students to display competencies which may be expressed in reflective narratives. Geriatric education experts used qualitative consensus methods to identify themes expressed in second year medical student narratives which were mapped to ACGME Core Competencies. Concept searches operationalizing these same competencies were created from USMLS medical subject headings and applied to the electronic medical student portfolios. Concept mapping compared poorly by face validity to qualitative consensus methodology in identifying competencies and issues of context displayed by student narratives. Assessment of electronic portfolios for ACGME Core Competencies may have to await more robust vocabulary to create concept identifiers capable of responding to issues of context for competencies such as ACGME Core Competencies reflecting sociologic and anthropologic content