Adapting the MSPE: Lessons from a Decade of Innovation

February 22, 2024

The Medical School Performance Evaluation (MSPE) letter is a critical component in a student’s medical education journey. It comprehensively evaluates the student’s academic and professional performance throughout their time in Undergraduate Medical Education. This document is essential for matching the student with the residency program that best fits their qualifications and aspirations.

Previously, we discussed how rising automation impacts the production and delivery of these documents. This week on the Holistic Success Show, we welcome Dr. Tanja Adonizio, Associate Dean of Student Affairs at Geisinger Commonwealth School of Medicine in Scranton, Pennsylvania, to tell us about her experience evolving the MSPE over the last ten years.

Why is the MSPE so important?

Let’s start with the big picture. The MSPE holds immense value for students as it showcases their professional and academic journey. This document is instrumental in helping students match with residency programs and take the first step toward their dream careers. The MSPE is like a key, unlocking doors of endless opportunities and possibilities. With the proper guidance, this document can be the key to opening the door to a bright and promising future.

Tanja Adonizio likes to use the framework of “the right possible residency programs matching up with the right future residents” when considering MSPEs. The graduating students display an incredible variety of backgrounds, talents, and experiences when they come to residency. They’ve met the standards, demonstrated the competencies, and reflected on their journey through personal statements.

How has the MSPE process changed over the years?

The MSPE is a highly personalized document that has undergone significant changes since its introduction, most recently due to the AAMC MSPE Task Force recommendations in 2016.

Dr. Adonizio’s first work with MSPEs was supporting the first graduating class of Geisinger Commonwealth School of Medicine in 2013, and taking on the Associate Dean of Student Affairs role in 2016, with full responsibility for the MSPEs, she found herself amidst a sea of change. Jumping into the deep end, Adonizio immersed herself in the national discourse, joining many sessions and conferences.

At that time, the process for creating MSPEs at Geisinger Commonwealth School of Medicine only involved Adonizio and a single administrative assistant who collaborated with many other offices at the school to gather all of the data and content for the letters. They would create Word documents for each student, and copy and paste the work into their school’s MSPE template. This involved a significant number of hours and manual data entry with potential for human error.

Luckily, the two-person team also had a process set up for students to review their MSPEs asynchronously and give feedback, questions, or errors that they had found. While helpful, the process also multiplied the time needed to review, revise, and communicate with students.

Recent changes to the MSPE process

Since 2016, Dr. Adonizio has been working to improve the MSPE process at Geisinger, with a focus on continuous quality improvement. Her goal with the MSPE improvements was for a clear, concise, and valuable process that ensures transparency for everyone involved, and supports their wellbeing, as well. To reach this goal, she focused on the following areas:

Stakeholder engagement and partnerships: We’ve seen how important it is to get stakeholders from every level involved and onboard on such a large project like this. To make a process work, you need to talk to the people who that process will impact. Speaking to program directors, career coaches, students, and faculty and getting their input early and continuously makes it easier to create high-quality and accurate letters. For example, our career coaches now work with students to craft their noteworthy characteristics to help ensure the best outcomes.

Reducing human error: Copying and pasting various documents into an MSPE template was laborious and open to human error. Dr. Adonizio aimed for a process that decreased the potential for error through automation and was able to adapt to curriculum changes or unpredictable events like the COVID-19 pandemic.

Increased transparency for students: Now, the structure of the MSPE letter is shared early in our students’ journey through our program so that they can anticipate what the contents will be and better understand the process. This helps to decrease anxiety in our students on this important piece of their residency application.

Dr. Adonizio has noted many benefits and efficiencies through these implemented changes. The most important are the decreased individual investment of time and a greater buy-in from everyone participating in the process.

What change looks like in practice

Change is the perpetual practice of continuous quality improvement. Geisinger’s updates to its MSPE process involved several key steps:

The MSPE template and timeline are revised annually based on data gathered and organized throughout the year.
Communication with stakeholders, including students, faculty, and staff, is emphasized throughout the process.
The editing phase involves a standardized approach, with trained editors focusing on consistency and grammar, including Oxford commas and preferred names/pronouns.
Students also have the opportunity to review a draft of their MSPE with their advisor, their assigned Regional Assistant Dean of Student Affairs, facilitating real-time discussion and support for their transition to residency.

Overall, the iterative nature of the process ensures continuous improvement and support for students’ development.