The standardized letter of evaluation (SLOE) in emergency medicine: The internal validity of the SLOE 2.0
Alexandra Mannix, Cullen B. Hegarty, Sharon Bord, Thomas Beardsley, Sandra Monteiro, Alai Alvarez, Teresa Davis, Katarzyna Gore, Melissa Parsons, Aman Pandey, Sara M. Krzyzaniak, Michael GottliebAbstract
Background
The standardized letter of evaluation (SLOE) is a crucial component of emergency medicine (EM) residency applications. Initially developed in 1995 and revised to electronic SLOE (eSLOE) 2.0, this tool aims to provide a standardized evaluation of medical students.
Objective
This study aimed to conduct internal validation by analyzing the distribution and correlation of scores in eSLOE 2.0 and identify any ranking skew.
Methods
A multi‐institutional cross‐sectional study conducted using eSLOE 2.0 data from applicants to five geographically diverse U.S. EM residency programs during the 2022–2023 application cycle. Data from 2891 eSLOE 2.0 s across 1633 applicants were analyzed using descriptive statistics, chi‐square, and Spearman's rho.
Results
Scores for all questions were moderately left‐skewed. The mean scores for all part B questions were above 4.0. Strong correlations were found between part A and B scores with anticipated guidance (AG) and rank list (RL) positions. The AG had a higher correlation with RL positions than grades. The mean RL score indicated that the average student fell between the middle and top thirds.
Conclusions
The study demonstrates left skew in eSLOE 2.0 scoring, including a higher prevalence of scores in the fully and mostly entrustable ranges for part A and the consistently high scores in part B.