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Common Assessment Form Guide

The UNC MD Program uses the Common Assessment Form that allows faculty, preceptors, fellows, and residents to evaluate medical student performance in the clinical setting.  Below is important information and instructions.

Common Assessment
Form Guide

Common Assessment
Form Comment Guide

Conflict of Interest

UNC School of medicine policy states that a resident or attending cannot evaluate the academic performance of any student for whom they have provided health care (including psychological and reproductive health care). If you identify a conflict of interest, please contact the course director or coordinator immediately in order to assign appropriate evaluators.

Common Assessment Form Basics

  • Complete Common Assessment Forms in a timely manner so that the UNC School of Medicine complies with accreditation standards.
  • The school uses the One45 system to evaluate students.  More information on One45.   If you need help, send email to one45-support@listserv.med.unc.edu
  • The forms are not anonymous.
  • The Common Assessment Form assesses student performance on each of the UNC SOM Core Competencies.  For each competency you can ‘hover’ over the underlined text in each competency for details.

Key Points for Grading

The form uses a 5-point Likert scale.  Please complete the form based on the student’s expected level of training (e.g., third or fourth-year student).  Download Common Assessment Form Guide.

  • Level 4 or 5: Exceeding expectations. Superstar student.
  • Level 3:  Meeting expectations.  A student who is on target.
  • Level 1 or 2: Not meeting expectations.  Red flag student.  Red flags are concerning and indicate that the student is at risk for failure. Please explain your choice in detail and contact the course director.
  • Not Observed: If you were unable to assess a competency please select the ‘Not Observed’ option (button to far left of form).  This selection does not penalize the student. However, by the end of the rotation students should be evaluated in all competencies.

Comments

Your input is very important for the student’s development and to contribute to the student’s Dean’s Letter (also referred to as the Medical Student Performance Evaluation or MSPE).  Please provide detailed comments, using examples when necessary. There are two sections for comments and both are visible to students.  Download Guide for Comments.

  • For Dean’s Letter Comments: (Official comments to be included in the Dean’s Letter)
    • Summarize performance
    • Address Knowledge, Skills, and Abilities.
    • Relate to competencies and learning objectives of the clerkship.
    • Cite specific positive examples.
  • Formative Comments (will not be included in the Dean’s Letter)
    • Provide honest feedback for growth.
    • Explain deficiencies, specific using examples.
    • Provide encouragement.
    • Offer behaviorally based feedback that is non-judgmental.