Grading

I do not know anyone who has smartness. The people I know sometimes do smart things . . . and sometimes do dumb things-depending on what circumstances they are in, how much they know about a situation, and how interested they are. Smartness, so it seems to me, is a specific performance, done in a particular set of circumstances. It is not something you are or have in measurable quantities. In fact, the assumption that smartness is something you have has led to such nonsensical terms as over- and underachievers. As I understand it, an overachiever is someone who doesn't have much smartness but does a lot of smart things. An underachiever is someone who has a lot of smartness but does a lot of dumb things.

-Neil Postman in ``The End of Education''

Our job together is maximizing the smart things that we do for patients (present and future) and minimizing the dumb things that we do. And if I had my way, we would keep working together until we reached the necessary degree of effectiveness: excellence. When teaching any skill, you can fix the learning time and let final performance vary. That's what our educational system has done historically, and is still doing: everyone spends a fixed amount of time in high school, or college, or medical school, and in the end some get high grades and some get low. OR you can fix the required performance standards (at the level of excellence) and let the time needed to achieve this level of performance vary-some students could achieve excellence in patient care in 2 years, some in 4, some in 8, etc. Progressing up through the various colored belts of martial arts training is a good example. I much prefer the latter method; it's what our patients deserve.

Unfortunately, I am not empowered to implement the above reforms. Formal grades are required by the University, and in fact, in spring of 2001, the Medical College Assembly approved a policy that specifies the proportions of Honors, High Pass, and Pass grades allowed in a rotation. Thus, the grading system for this course is detailed here. No grading system is perfect. This one is no better than any of dozens of others that could be imagined. The only advantage to this grading system is that it is here, on paper, in front of all of us. If nothing else, at least we all know what the policy is.

Table 4 shows the components of our grading scheme, comprising 500 points altogether.

Table 4: Grading scheme

	Maximum
Element	earnable score
preceptor evaluation	250
OSCE	100
written exam 1	50
written exam 2	50
homework assignments	50
TOTAL	500

Any assignment that is handed in late will receive a score of zero.

Similarly, students not participating in any particular component of the grading scheme will receive zero points for that component.

Final course grades will be assigned as follows:

Some components warrant further explanation: