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Uncertainty in Standardized Letter of Evaluation Authorship: A Qualitative Study of Emergency Medicine Faculty.

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Title: Uncertainty in Standardized Letter of Evaluation Authorship: A Qualitative Study of Emergency Medicine Faculty.
Authors: Schrepel, Caitlin1 (AUTHOR) caipsch@uw.edu, Shappell, Eric2 (AUTHOR), Sehdev, Morgan3 (AUTHOR), Dubosh, Nicole M.4 (AUTHOR), Schnapp, Benjamin H.5 (AUTHOR), Pelletier‐Bui, Alexis6 (AUTHOR), Hegarty, Cullen7,8 (AUTHOR), Bord, Sharon9 (AUTHOR)
Source: AEM Education & Training. Jun2026, Vol. 10 Issue 3, p1-7. 7p.
Subject Terms: *Authorship, *Qualitative research, *Residents (Medicine), *Teacher development, Emergency medicine
Abstract: Background: The standardized letter of evaluation (SLOE) is a cornerstone of emergency medicine (EM) residency selection. While prior research has focused on how SLOEs are interpreted by reviewers, less is known about the considerations and strategies faculty employ when authoring these high‐stakes evaluations. Methods: Using a constructivist grounded theory approach, we conducted semi‐structured interviews with EM faculty experienced in SLOE authorship between April and October 2025. Interviews were audio‐recorded, transcribed, and iteratively analyzed using constant comparative methods and team‐based reflexive analysis until thematic sufficiency was achieved. Results: Participants described SLOE authorship as a process of navigating uncertainty arising from the interaction of structural challenges, cultural pressures, and moral tensions. Structurally, authors described difficulty mapping incomplete or imperfect evaluation data onto standardized SLOE items, often requiring interpretive judgment and use of proxies. Culturally, participants reported pressure to calibrate ratings to perceived national norms to avoid disadvantaging students, contributing to grade inflation and narrative justification strategies. Morally, authors experienced tension between transparency and advocacy, balancing honest assessment with concern for learner success and professional credibility. Conclusion: Recognizing uncertainty as a central feature of SLOE authorship underscores the need for improved alignment between clerkship evaluations and SLOE formats, clearer national calibration practices, and faculty development that supports authors in their dual roles as evaluators and mentors. Collectively, these efforts may improve the credibility and consistency of this crucial part of the EM residency application. [ABSTRACT FROM AUTHOR]
Copyright of AEM Education & Training is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Education Research Complete
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  Data: Uncertainty in Standardized Letter of Evaluation Authorship: A Qualitative Study of Emergency Medicine Faculty.
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  Data: <searchLink fieldCode="AR" term="%22Schrepel%2C+Caitlin%22">Schrepel, Caitlin</searchLink><relatesTo>1</relatesTo> (AUTHOR)<i> caipsch@uw.edu</i><br /><searchLink fieldCode="AR" term="%22Shappell%2C+Eric%22">Shappell, Eric</searchLink><relatesTo>2</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Sehdev%2C+Morgan%22">Sehdev, Morgan</searchLink><relatesTo>3</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Dubosh%2C+Nicole+M%2E%22">Dubosh, Nicole M.</searchLink><relatesTo>4</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Schnapp%2C+Benjamin+H%2E%22">Schnapp, Benjamin H.</searchLink><relatesTo>5</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Pelletier‐Bui%2C+Alexis%22">Pelletier‐Bui, Alexis</searchLink><relatesTo>6</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Hegarty%2C+Cullen%22">Hegarty, Cullen</searchLink><relatesTo>7,8</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Bord%2C+Sharon%22">Bord, Sharon</searchLink><relatesTo>9</relatesTo> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22AEM+Education+%26+Training%22">AEM Education & Training</searchLink>. Jun2026, Vol. 10 Issue 3, p1-7. 7p.
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  Data: *<searchLink fieldCode="DE" term="%22Authorship%22">Authorship</searchLink><br />*<searchLink fieldCode="DE" term="%22Qualitative+research%22">Qualitative research</searchLink><br />*<searchLink fieldCode="DE" term="%22Residents+%28Medicine%29%22">Residents (Medicine)</searchLink><br />*<searchLink fieldCode="DE" term="%22Teacher+development%22">Teacher development</searchLink><br /><searchLink fieldCode="DE" term="%22Emergency+medicine%22">Emergency medicine</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Background: The standardized letter of evaluation (SLOE) is a cornerstone of emergency medicine (EM) residency selection. While prior research has focused on how SLOEs are interpreted by reviewers, less is known about the considerations and strategies faculty employ when authoring these high‐stakes evaluations. Methods: Using a constructivist grounded theory approach, we conducted semi‐structured interviews with EM faculty experienced in SLOE authorship between April and October 2025. Interviews were audio‐recorded, transcribed, and iteratively analyzed using constant comparative methods and team‐based reflexive analysis until thematic sufficiency was achieved. Results: Participants described SLOE authorship as a process of navigating uncertainty arising from the interaction of structural challenges, cultural pressures, and moral tensions. Structurally, authors described difficulty mapping incomplete or imperfect evaluation data onto standardized SLOE items, often requiring interpretive judgment and use of proxies. Culturally, participants reported pressure to calibrate ratings to perceived national norms to avoid disadvantaging students, contributing to grade inflation and narrative justification strategies. Morally, authors experienced tension between transparency and advocacy, balancing honest assessment with concern for learner success and professional credibility. Conclusion: Recognizing uncertainty as a central feature of SLOE authorship underscores the need for improved alignment between clerkship evaluations and SLOE formats, clearer national calibration practices, and faculty development that supports authors in their dual roles as evaluators and mentors. Collectively, these efforts may improve the credibility and consistency of this crucial part of the EM residency application. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
  Label:
  Group: Ab
  Data: <i>Copyright of AEM Education & Training is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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              Text: Jun2026
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              Y: 2026
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