Blinded Versus Unblinded Evaluation: Effects on Student Clinical Performance Ratings

INTRODUCTION: The purpose of this study was to examine differences in student and clinical instructor (CI) ratings on the Clinical Internship Evaluation Tool (CIET) and determine the influence of CIs being able to view student ratings as they scored students versus not being able to view student ratings. REVIEW OF LITERATURE: Various forms of bias can influence the assessment of student performance. Clinical instructors are meant to be objective evaluators of students but are susceptible to known and unknown biases. Students should receive timely and accurate feedback that holds limited bias so they can learn and grow throughout their clinical education experiences. SUBJECTS: One hundred seventy-six second-year Doctor of Physical Therapy (DPT) students and their CIs (93 students paired with 93 CIs in cohort 1; 83 students paired with 83 CIs in cohort 2). METHODS: Students and CIs across 2 DPT cohorts were trained to score the CIET. Students and CIs completed the CIET at midterm and final time points of the first, 8-week clinical experience. Clinical instructors were able to view student ratings in cohort 1 but were blinded to student ratings in cohort 2. RESULTS: Across both cohorts, CIET ratings for professional behavior and patient management improved over time (P < .001). Differences in student-CI ratings were more pronounced in cohort 2 (P < .001). A significant rater by cohort interaction for patient management items (P < .001) revealed larger discrepancies in the blinded group. DISCUSSION AND CONCLUSION: Clinical instructor access to student self-assessments may influence rating alignment for both Professional Behaviors and Patient Management items on the CIET. Clinical instructors rate student performance lower when blinded to student ratings. Thus, viewing a student's self-assessment may bias a CI's assessment of the student.