eSLOE 2.0: Examining Data From the First 2 Application Cycles of the Updated Emergency Medicine Electronic Standardized Letter of Evaluation

Sharon Bord¹, Erin Karl², Doug Franzen³, Cullen B Hegarty⁴, Joseph B House⁵, Katherine M Hiller⁶, Kevin Hamilton⁷, Alexis Pelletier-Bui⁸

Affiliations

¹ is a Clerkship and Subinternship Director and Assistant Professor, Department of Emergency Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
² is an Associate Program Director and Clerkship Director, Hennepin County Medical Center Emergency Medicine Residency, and Assistant Professor, Department of Emergency Medicine, University of Minnesota, Minneapolis, Minnesota, USA.
³ is an Associate Professor, Department of Emergency Medicine, University of Washington, Seattle, Washington, USA.
⁴ is a Program Director, Emergency Medicine Residency, HealthPartners Institute/Regions Hospital, and Professor, Department of Emergency Medicine, University of Minnesota, Minneapolis, Minnesota, USA.
⁵ is a Clerkship Director and Professor of Emergency Medicine and Pediatrics, University of Michigan Medical School, Ann Arbor, Michigan, USA.
⁶ is an Associate Dean, Regional Director, and Professor, Department of Emergency Medicine, Indiana University School of Medicine, and Chief Academic Officer, Indiana University Health, South Central Region, Bloomington, Indiana, USA.
⁷ is a Manager, Software Engineering, University of Maryland Medical System, Baltimore, Maryland, USA.
⁸ is an Associate Program Director, Emergency Medicine Residency, and Assistant Professor, Department of Emergency Medicine, Cooper University Hospital/Cooper Medical School of Rowan University, Camden, New Jersey, USA.

PMID: 40417096
PMCID: PMC12096113
DOI: 10.4300/JGME-D-24-00501.1

eSLOE 2.0: Examining Data From the First 2 Application Cycles of the Updated Emergency Medicine Electronic Standardized Letter of Evaluation

Sharon Bord et al. J Grad Med Educ. 2025 Apr.

. 2025 Apr;17(2):211-216.

doi: 10.4300/JGME-D-24-00501.1. Epub 2025 Apr 15.

Authors

Sharon Bord¹, Erin Karl², Doug Franzen³, Cullen B Hegarty⁴, Joseph B House⁵, Katherine M Hiller⁶, Kevin Hamilton⁷, Alexis Pelletier-Bui⁸

Affiliations

¹ is a Clerkship and Subinternship Director and Assistant Professor, Department of Emergency Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
² is an Associate Program Director and Clerkship Director, Hennepin County Medical Center Emergency Medicine Residency, and Assistant Professor, Department of Emergency Medicine, University of Minnesota, Minneapolis, Minnesota, USA.
³ is an Associate Professor, Department of Emergency Medicine, University of Washington, Seattle, Washington, USA.
⁴ is a Program Director, Emergency Medicine Residency, HealthPartners Institute/Regions Hospital, and Professor, Department of Emergency Medicine, University of Minnesota, Minneapolis, Minnesota, USA.
⁵ is a Clerkship Director and Professor of Emergency Medicine and Pediatrics, University of Michigan Medical School, Ann Arbor, Michigan, USA.
⁶ is an Associate Dean, Regional Director, and Professor, Department of Emergency Medicine, Indiana University School of Medicine, and Chief Academic Officer, Indiana University Health, South Central Region, Bloomington, Indiana, USA.
⁷ is a Manager, Software Engineering, University of Maryland Medical System, Baltimore, Maryland, USA.
⁸ is an Associate Program Director, Emergency Medicine Residency, and Assistant Professor, Department of Emergency Medicine, Cooper University Hospital/Cooper Medical School of Rowan University, Camden, New Jersey, USA.

PMID: 40417096
PMCID: PMC12096113
DOI: 10.4300/JGME-D-24-00501.1

Abstract

Background The emergency medicine (EM) Standardized Letter of Evaluation (SLOE) was created to provide a standardized, concise, and differentiated evaluation of EM residency applicants. It was revised in 2022 (eSLOE 2.0) to better align with the shift toward competency-based evaluations in undergraduate and graduate medical education. Objective To investigate how applicants were rated by evaluators on the new competency-based component and revised normative-based components of the eSLOE 2.0 and to establish preliminary validity for the new letter format. Methods Data from the first 2 application cycles utilizing the eSLOE 2.0 (2022-2023, 2023-2024) were accessed via a national EM database. The data specifically from parts A (core EM clinical skills), B (professionalism and interpersonal skills), and C (anticipated guidance during residency and rank list placement) were examined. Results Data from the 11 789 letters, representing 6543 unique applicants, revealed that 44.8% to 71.7% of applicants were designated as fully entrustable, and 27% to 50.7% as mostly entrustable on part A skills. Most applicants (81.7% to 85.7%) were placed as either 4 or 5 (1-5 Likert scale) in each part B skill. Nearly fifty-two percent (n=6076) were anticipated to need standard guidance in residency, while 32.8% (n=3872) were anticipated to need minimal guidance and 15.6% (n=1841) to need moderate or most guidance. In part C, 20.5% (n=2414) were designated as being in the top 10% on the rank list, 37.2% (n=4381) in the top third, 31.6% (n=3727) in the middle third, and 10.0% (n=1178) in the lower third. Conclusions The findings from the first 2 years of utilizing the eSLOE 2.0 format offer preliminary validity data on this new letter format.

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Figures

**Figure 1**
Electronic Standardized Letter of Evaluation (eSLOE) 2.0, Part A Category Distribution (2022-2024)

**Figure 2**
Electronic Standardized Letter of Evaluation (eSLOE) 2.0, Part B Likert Scale Distribution (2022-2024)

**Figure 3**
Emergency Medicine Electronic Standardized Letter of Evaluation (eSLOE) 2.0, Part C Anticipated Guidance Needed During Residency (2022-2024)

**Figure 4**
Emergency Medicine Electronic Standardized Letter of Evaluation (eSLOE) 2.0, Estimated Position on the Rank List (2022-2024)

See this image and copyright information in PMC

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eSLOE 2.0: Examining Data From the First 2 Application Cycles of the Updated Emergency Medicine Electronic Standardized Letter of Evaluation

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eSLOE 2.0: Examining Data From the First 2 Application Cycles of the Updated Emergency Medicine Electronic Standardized Letter of Evaluation

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