The "good" dean's letter.

PURPOSE: To determine whether a correlation exists between the term "good" on the summative, comparative assessment of a student's Medical Student Performance Evaluation (MSPE) and his or her actual performance in medical school.

METHOD: The authors reviewed the MSPEs submitted to three residency programs to determine the presence of the term "good" in either the summary paragraph or the appendices. Next, they noted, for institutions using "good," the percentile rankings of those students who received "good" as a descriptor. To examine the consistency among institutions regarding the percentile ranking denoted by "good," they dichotomized the data into students below and above the bottom 25th percentile. They analyzed the data using a nonparametric test because of their nonnormal distribution.

RESULTS: The authors collected MSPEs from 122 of the 125 Liaison Committee on Medical Education-accredited medical schools that were graduating students in 2008. Of these 122 institutions, 34 (28%) used the term "good." All 34 institutions used the term to characterize students in the bottom 50% of the graduating class. The authors found a significant difference in the percentile ranking of students described as "good" between institutions using it to describe the bottom 25% and institutions using the term to describe those in the 25th to 50th percentiles (median ranking of 12.5% versus 30%, P < .0001).

CONCLUSIONS: Overall, the term "good" in the MSPE describes students in the bottom 50% of the class; therefore, the term "good," as used to describe performance in medical school, consistently indicates below-average performance.