ACGMEmojis: the modified visual analog scale

In recent years, medical education has undergone a major overhaul in philosophy. There has been a steady shift away from the traditionally competitive culture of medical education to a more nurturing way of educating our future doctors.

In the past, scores were publically displayed to shame the underachievers to essentially shape up or ship out. Next, the grading system changed to ”honors”, “high pass”, “pass”, or “fail”. In the recent years, more medical schools have adopted the “pass/fail” system, aiming to further de-emphasize competition among colleagues and to encourage students to focus on learning and not on grades.

“As you can imagine, when students don’t have to worry so much about competing against one another, they can focus on learning for the sake of learning, and not for the sake of getting good grades,” says a medical educator at Pacific Northwest School of Medicine. “In fact, our students never fail. We have three grades: Honors, High Honors, and Highest Honors”.

Last year, a ground-breaking survey of medical students showed that 98% of medical students would be emotionally devastated if they got anything under “honors”.

In response to this survey, the ACGME has quickly come up with the ACGMEmoji scale. In fact, this would be the first validated visual analog scale to give resident feedback.

Medical educators across the nation are anticipting that this scale will spur a shift in paradigm in terms of resident evalution. As soon as it was published, excitement swept across the nation.

“I think this is genius.” says a second year resident in a Northern New England Hospital. “The ACGMEmojis would make it so much easier to understand how I’m doing. It is as if the ACGME is finally speaking our language.”

A representative of the ACGME explained that their committee “was inspired by the Visual Analog Scale, which simply put, is a scale of unhappy to happy smiling face emojis. It is so simple and universal that small children or people who speak other languages can use it.”

“But we did feel that just the smiley faces were too limiting. We went ahead and expanded the scale to include other emojis. Afterall, the language of emojis is getting more and more sophisticated and we should take advantage of this.”

There are some who would argue, however, that certain emojis are open to interpretation and can be vague. For example, the poop emoji could be interpretted as someone being “hot shit” or “pretty darn shitty”. The fist emoji could be a fist pump or the evaluator wants to punch the trainee in the face.

In the next few years, the acgme aims to 1) iron out these potential issues as well as 2) expand the repertoire of ACGMEmojis to incorporate animations or memojis to personalize the feedback even more and to soften up the blow of any negative remarks.