Competency-based education; Debriefing; Debriefing assessment; Digital rater training; Faculty development; Medical education assessment; Online training; Rater training; Staged learning; Psychiatric Mental Health; Ecology, Evolution, Behavior and Systematics; Social Sciences (all); Psychology (all); Developmental Neuroscience; Cognitive Neuroscience
Abstract :
[en] Trustworthy simulation-based assessment depends on capable raters-but current approaches to rater training are often resource-intensive, inconsistently effective, and conceptually muddled. In practice, many programs focus on delivering training activities (e.g., frame-of-reference or behavioral observation training) without a clear model of the steps that build reliable, trustworthy assessments.We clarify the pathway to reliable, trustworthy assessment skills by distinguishing rater cognition-the cognitive work of recognizing, interpreting, and judging performance-from rater training, the educational processes intended to develop that capability. Rating is not a mechanical act of applying a rubric; it is a skilled perceptual and interpretive process. As we argue, a rubric does not do the seeing for you. While rubrics externalize expert judgment, raters must be trained to recognize and apply that expertise-learning to distinguish observable data from inference and to "see through the eyes of the rubric." Traditional rater training approaches can be reframed as mechanisms that build this underlying cognitive skill.Building on this conceptual clarification, we introduce a staged learning framework for rater readiness. Rather than treating training as a one-time intervention, we propose that raters must be prepared developmentally: first through foundational deliberate practice, then through situational application, and finally through expert-facilitated calibration and ongoing feedback.We illustrate this model through a pilot of an interactive, technology-enabled, partially asynchronous rater training program for the Advocacy-Inquiry Rubric. This pilot shows how simulation programs can greatly reduce the time required from experts to train raters, while also demonstrating feasibility, strong usability, and promising reliability outcomes.
Disciplines :
Education & instruction
Author, co-author :
Setnik, Lon; Center for Medical Simulation, 100 First Avenue Suite 400, Boston, MA, 02129, USA. lsetnik@harvardmedsim.org
Park, Yoon Soo; Department of Medical Educatio, University of Illinois College of Medicine, 808 South Wood Street, Chicago, IL, 60612, USA
Buleon, Clément ; Université de Liège - ULiège > Département des sciences cliniques > Médecine d'urgence ; Center for Medical Simulation, 100 First Avenue Suite 400, Boston, MA, 02129, USA ; Center for Medical Simulation of Normandie, NorSimS, University Hospital of Caen, Caen, France
Szyld, Demian; Center for Medical Simulation, 100 First Avenue Suite 400, Boston, MA, 02129, USA ; Department of Emergency Medicine, Boston Medical Center and Boston University Chobanian & Avedisian School of Medicine, 725 Albany Street, Boston, MA, 02118, USA
Rudolph, Jenny; Center for Medical Simulation, 100 First Avenue Suite 400, Boston, MA, 02129, USA ; Harvard Medical School and Department of Anesthesia Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Boston, USA
Language :
English
Title :
Teaching raters to see: A faculty development innovation for robust assessment in health professions education.
Alternative titles :
[fr] Apprendre aux évaluateurs à « voir » : une innovation en matière de formation des enseignants pour une évaluation rigoureuse dans la formation aux métiers de santé.
Gauthier G St-Onge C Tavares W Rater cognition: review and integration of research findings Med Educ 2016 50 5 511 22 10.1111/medu.12973 27072440
Raufaste E Eyrolle H Mariné C Pertinence Generation in Radiological Diagnosis: Spreading Activation and the Nature of Expertise Cogn Sci 1998 22 4 517 46 10.1207/s15516709cog2204_4
Schmutz J Eppich WJ Hoffmann F Heimberg E Manser T Five Steps to Develop Checklists for Evaluating Clinical Performance: An Integrative Approach Acad Med 2014 89 7 996 1005 10.1097/ACM.0000000000000289 24826862
Gorman CA Rentsch JR Evaluating frame-of-reference rater training effectiveness using performance schema accuracy J Appl Psychol 2009 94 5 1336 44 10.1037/a0016476 19702375
McGaghie WC, Barsuk JH, Wayne DB. Mastery Learning With Deliberate Practice in Medical Education: Academic Medicine. 2015;90(11):1575. https://doi.org/10.1097/ACM.0000000000000876.
Hunt EA Duval-Arnould JM Nelson-McMillan KL et al. Pediatric resident resuscitation skills improve after Rapid Cycle Deliberate Practice training Resuscitation 2014 85 7 945 51 10.1016/j.resuscitation.2014.02.025 24607871
Kahneman D, Sibony O, Sunstein CR. Noise: a flaw in human judgment. 1st pbk ed. New York: Little, Brown Spark; 2022.
Hauenstein NM. Training raters to increase the accuracy of appraisals and the usefulness of feedback. Performance appraisal: State of the Art in Practice. 1998:404–42.
Grow GO Teaching Learners To Be Self-Directed Adult Educ Q 1991 41 3 125 49 10.1177/0001848191041003001
Roussin CJ Weinstock P SimZones: An Organizational Innovation for Simulation Programs and Centers Acad Med 2017 92 8 1114 20 10.1097/ACM.0000000000001746 28562455
Anders Ericsson K Deliberate Practice and Acquisition of Expert Performance: A General Overview Acad Emerg Med 2008 15 11 988 94 10.1111/j.1553-2712.2008.00227.x 18778378
Kirschner PA Sweller J Clark RE Why Minimal Guidance During Instruction Does Not Work: An Analysis of the Failure of Constructivist, Discovery, Problem-Based, Experiential, and Inquiry-Based Teaching Educational Psychol 2006 41 2 75 86 10.1207/s15326985ep4102_1
Tavares W Kinnear B Schumacher DJ Forte M Rater training re-imagined for work-based assessment in medical education Adv Health Sci Educ 2023 28 5 1697 709 10.1007/s10459-023-10237-8
Barrett LF Gross J Christensen TC Benvenuto M Knowing what you’re feeling and knowing what to do about it: Mapping the relation between emotion differentiation and emotion regulation Cognition Emot 2001 15 6 713 24 10.1080/02699930143000239
Buléon C, Szyld D, Simon R, Setnik L, Eppich WJ, Fey M, et al. The Advocacy-Inquiry Rubric (AIR): a standard to build debriefing and feedback skills. Adv Simul. 2025;10(1):60. https://doi.org/10.1186/s41077-025-00381-z.
Rudolph JW Simon R Dufresne RL Raemer DB There’s No Such Thing as Nonjudgmental Debriefing: A Theory and Method for Debriefing with Good Judgment Simul Healthc 2006 1 1 7 10.1097/01266021-200600110-00006
Clark CM Fey MK Fostering Civility in Learning Conversations: Introducing the PAAIL Communication Strategy Nurse Educ 2020 45 3 139 43 10.1097/NNE.0000000000000731 31498196
Roussin CJ Ng G Fey MK Lipshaw JA Arantes HP Rudolph JW Readiness planning: how to go beyond buy-in to achieve curricular success and front-line performance Adv Simul 2024 9 1 50 10.1186/s41077-024-00317-z
Koo TK Li MY A Guideline of Selecting and Reporting Intraclass Correlation Coefficients for Reliability Research J Chiropr Med 2016 15 2 155 63 10.1016/j.jcm.2016.02.012 27330520 4913118
Stemler SE. A Comparison of consensus, consistency, and measurement approaches to estimating interrater reliability. Practical Assess Res Evaluation. 2004;9(4). https://doi.org/10.7275/96JP-XZ07.
Brooke J SUS - A quick and dirty usability scale Usability evaluation Ind 1996 189 3 8
Peres SC, Pham T, Phillips R. Validation of the System Usability Scale (SUS): SUS in the wild. Proc Hum Factors Ergon Soc Annual Meeting. 2013;57(1):192–6. https://doi.org/10.1177/1541931213571043.
Lewis JR The System Usability Scale: Past, Present, and Future Int J Human–Computer Interact 2018 34 7 577 90 10.1080/10447318.2018.1455307
Bandura A. Social cognitive theory of self-regulation. Organ Behav Hum Decis Process. 1991;50(2):248–87.
Barsuk JH McGaghie WC Cohen ER Balachandran JS Wayne DB Use of simulation-based mastery learning to improve the quality of central venous catheter placement in a medical intensive care unit J Hosp Med 2009 4 7 397 403 10.1002/jhm.468 19753568