J Korean Soc Emerg Med.  2020 Jun;31(3):315-322.

Experience of essay during the clinical clerkship in emergency medicine and inter-rater reliability on essay

  • 1Department of Emergency Medicine, Dong-A University Hospital, Busan, Korea
  • 2Department of Emergency Medicine, Dong-A University, College of Medicine, Busan, Korea


An essay test is difficult to carry out because of the effort for hand scoring and the concerns about inter-rater reliability, even though the use of a rubric can increase inter-rater reliability. This study examined the feasibility of an essay test in medical school students and whether the use of a rubric increases inter-rater reliability.
An essay test was given to 51 undergraduate students in the third grade of emergency medicine clinical clerkship. Three raters assessed the essay test independently with a prepared rubric immediately after the test. They then did the same essay test without a rubric three months later. The researchers compared the Pearson’s correlation coefficients between raters. The researchers analyzed the validity comparing the correlation coefficient between the essay test and previous multiple-choice questions (MCQ) and feasibility by acceptance.
Fifty-one students took the essay test. The Pearson’s correlation coefficient using rubric between raters 1 and 2, 1 and 3, and 2 and 3 were 0.898 (P<0.001), 0.896 (P<0.001), and 0.856 (P<0.001), respectively. Without a rubric, the correlation coefficients were 0.838 (P<0.001), 0.888 (P<0.001), and 0.824 (P<0.001), respectively. The new essay test showed a positive correlation (0.367) with the previous MCQ, and the evidence for validity and feasibility was acceptable.
In this study, the rubric did not increase the inter-rater reliability of the essay test. On the other hand, the inter-rater reliability was higher than 0.8, even without a rubric. In addition, the essay test showed evidence of validity and feasibility.


Essays; Medical school; Emergency medicine; Reliability
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