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At least 19 recordsLinked to original sources
PubMed2002

Distributed Web-supported radiology clerkship for the required clinical clerkship year of medical school: development, implementation, and evaluation.

RATIONALE AND OBJECTIVES: The authors performed this study to develop, implement, and evaluate a new radiology clerkship for the required clinical clerkship year of medical school. MATERIALS AND METHODS: A mandatory radiology clerkship experience was added to the required clinical clerkships as a series of 10 independent half-day teaching sessions. These sessions were distributed as one session per existing clerkship throughout the year. To provide continuity and organization, Web-based curriculum materials were designed and implemented as a component of the radiology clerkship. The new clerkship was evaluated with observations, pretest and posttest measures with a control group, structured and unstructured student and faculty surveys, and individual and small group interviews. RESULTS: The clerkship was successfully developed and implemented. Ninety-five students have completed the clerkship. Their mean posttest score (84.8) was significantly higher than their mean pretest score (58.8, P < .001) and the mean control group score (59.7, P < .001). Students rarely used the Web site. Disadvantages of the distributed clerkship were identified. CONCLUSION: A radiology clerkship distributed among existing clerkships is feasible but has many disadvantages. Students greatly prefer live instruction, and Web-based educational materials are more valuable to faculty and administrators than to students.

Attitude↗
PubMed2006

Formative assessment promotes learning in undergraduate clinical clerkships.

INTRODUCTION: Clinical clerkships, typically situated in environments lacking educational structure, form the backbone of undergraduate medical training. The imperative to develop strategies that enhance learning in this context is apparent. This study explored the impact of longitudinal bedside formative assessment on student learning in a medical clerkship. METHODS: We studied a class of 4th-year students completing a 14-week medical clerkship at the University of Cape Town in South Africa. Clinician educators assessed student performance during weekly bedside teaching sessions using blinded patient encounters (in which students had no prior knowledge of the patient's diagnosis or access to the clinical records). Student feedback was standardised using performance rating scales. The impact of formative assessment on student learning was determined from questionnaire responses. RESULTS: A total of 575 formative assessments took place during the study period. Students perceived blinded patient encounters to be a valuable learning activity that improved their clinical reasoning skills and assessed progress fairly. They reported that feedback helped inform them of their level of competence and learning needs, motivated them to read more, and significantly improved their participation in patient-centred learning activities. Participating clinicians agreed that this formative assessment strategy enhanced the learning potential of bedside teaching sessions. CONCLUSIONS: Longitudinal formative assessment, using blinded patient encounters, was successfully integrated into undergraduate clerkship bedside teaching. According to both students and staff this assessment strategy enhanced bedside learning and improved student participation in patient-centred learning activities during the clerkship.

Clinical Clerkship↗
PubMed1991

Achievement of objectives: internal medicine fourth year clinical clerkship.

The clinical clerkship in Canadian Medical Schools is intended to provide senior medical students with opportunities to gain practical knowledge of clinical medicine, develop technical skills, learn to use judgement and experience first-hand clinical decision making. Assessment of rotations in internal medicine were undertaken in order to understand more fully the nature of medical clerkship experiences. We found that medical clerks in our programme were exposed to a high proportion of undifferentiated problems and an adequate case mix. They performed a wide range of technical procedures. There were, however, certain gaps in the clerks' experiences both in the specialty areas, and in therapeutic and technical procedures. Recognition of these gaps in the clerkship experiences suggest that further deliberation of goals and objectives is required and issues of achievement of competencies need to be addressed.

Adult↗
PubMed2006

Using a web-based, iterative education model to enhance clinical clerkships.

Although most clinical clerkship curricula are designed to provide all students consistent exposure to defined course objectives, it is clear that individual students are diverse in their backgrounds and baseline knowledge. Ideally, the learning process should be individualized towards the strengths and weakness of each student, but, until recently, this has proved prohibitively time-consuming. The authors describe a program to develop and evaluate an iterative, Web-based educational model assessing medical students' knowledge deficits and allowing targeted teaching shortly after their identification. Beginning in 2002, a new educational model was created, validated, and applied in a prospective fashion to medical students during an internal medicine clerkship at Harvard Medical School. Using a Web-based platform, five validated questions were delivered weekly and a specific knowledge deficiency identified. Teaching targeted to the deficiency was provided to an intervention cohort of five to seven students in each clerkship, though not to controls (the remaining 7-10 students). Effectiveness of this model was assessed by performance on the following week's posttest question. Specific deficiencies were readily identified weekly using this model. Throughout the year, however, deficiencies varied unpredictably. Teaching targeted to deficiencies resulted in significantly better performance on follow-up questioning compared to the performance of those who did not receive this intervention. This model was easily applied in an additive fashion to the current curriculum, and student acceptance was high. The authors conclude that a Web-based, iterative assessment model can effectively target specific curricular needs unique to each group; focus teaching in a rapid, formative, and highly efficient manner; and may improve the efficiency of traditional clerkship teaching.

Clinical Clerkship↗
PubMed1975

A clinical clerkship in psychiatry.

A clinical clerkship was organized around the goal of teaching information and skills that would be needed by the nonpsychiatrist physician. In most clinical clerkships the students work on an inpatient service. In the clerkship described here the setting is an outpatient clinic, which provides a more relevant experience. Videotaped psychiatric interviews are used extensively and have been found to provide a valuable teaching format. They are effective in holding student interest, in avoiding the practical difficulties of live interviews, and in teaching active listening and interviewing technique, as well as in demonstrating a variety of psychopathology. Field trips to state psychiatric hospitals, institutions for mental defectives, clinics for treating alcoholics or addicts, and other mental health facilities have been used but have not been found to be a very valuable part of the program.

Education, Medical, Undergraduate↗
PubMed2004

[Clinical clerkship of home care for medical students].

UNLABELLED: A clinical clerkship of home care has been introduced in our program for third-year medical students since 1998 at this university. In our clinical clerkship of home care, medical students are not only dispatched to visiting nursing stations, but they also participate in home care service activities with visiting nursing people at patients' homes. Through these experiences the students have an opportunity to study the policy of community medicine and home care, and to gain the knowledge of teamwork. OBJECTIVE AND METHOD: The clerkship of home care (1 week program) was introduced to all of the third-year medical students. The students were dispatched to visiting nursing stations and they had to take part in home care service activities at patients' homes with community care visiting nurses. After this program was finished, questionnaires were given to all the students and visiting nurses to examine the necessity and scheduling of this program and to evaluate the students by the visiting nurses, etc. RESULT: A total of 621 students participated in our program for the past 6 years since 1998, and 90 visiting nurses from 30 visiting nursing stations gave actual trainings to our students every year at patients' homes. 98% of the students as well as 97% of the home care nurses returned questionnaires. After the program, 95.1% of the students and 97.8% of the visiting nurses agreed that this program was meaningful for both sides and it should be continued. Furthermore, regarding a question of the suitability of the third-year medical students to be in the program, 70% of the students and 48% of the visiting nurses agreed. As to a question of the training duration, 80% of the students and 87% of the visiting nurses also agreed. Both students and visiting nurses were in agreement that this home care clerkship was important. Meanwhile, both students and visiting nurses also expressed a degree of some difficulty for this clinical clerkship training. These results suggested that there were some factors to be resolved in order to carry out the clinical clerkship as a success. The clinical trainings for community-based home care are not carried out sufficiently under present medical education because clinical clerkships are always performed at a bedside of a university hospital. It is hard for the students to learn community-based home care and the time related progression of a patient's disease. Therefore, clinical clerkship of home care is a good and effective method to educate the students in those areas.

Clinical Clerkship↗
PubMed1998

Problem based teaching and learning as a bridge from basic anatomy to clinical clerkships.

This article describes a Clinical Anatomy course designed to bridge basic anatomy with clinical clerkships. It is given in the second year, after the traditional dissecting anatomy course. Students revisit anatomy during small group discussions of clinical cases. An example of a case is described together with a summary of a typical group process stimulated by the case. The group process enables students to develop clinical thinking and problem solving skills fundamental to clinical practice. They learn to search for medical knowledge resources, and to work in teams. The tutor evaluates the students' progress based on their knowledge building, problem solving and development of their interpersonal skills. Problem based learning in this interdisciplinary anatomy course allows students and faculty both horizontal and vertical integration within the curriculum.

Anatomy↗
PubMed2003

Effect of clinical clerkship on students' attitudes toward medical learning in Japan: a case study at Kinki University School of Medicine.

A 20-item questionnaire was administered to 253 physicians and 111 medical students, who did not have previous clinical clerkship experience, upon completion of their clinical clerkship. Medical students responded that they enjoyed their clinical clerkships but felt pressured and physically tired. Ninety percent of these medical students developed expectations for their career choice during their clinical clerkship. Only 18% of physicians felt that they allowed students enough chance to participate in clinical practice. We must emphasize that the success of any clinical clerkship system depends on an effective communication system between physicians and medical students.

Journal Article↗
PubMed2005

Teaching medical informatics skills during a clinical clerkship.

Medical students use many forms of medical electronic resources (MER) during clinical clerkships. Such resources may be inaccurate, irrelevant or inappropriate, yet most medical students do not receive guidance on the use of MER. During the earliest clinical clerkship we gave a series of seminars and assignments on the use of MER. These were well accepted and were followed by increased knowledge in the use of MER.

Clinical Clerkship↗
PubMedDate not supplied

A pilot survey of patient-initiated assaults on medical students during clinical clerkship.

OBJECTIVES: To assess the incidents of patient-initiated assault (PIA) against clinical clerks during the first six months of clinical clerkship. To characterise the assaults with respect to service, location, clerk gender, patient gender. To examine the students' perceptions of the reporting process for PIA. METHODS: A brief email survey was sent to all third year medical students after six months of clinical clerkship experience. Students were asked to describe assault experiences including: location, service, patient gender and injuries sustained. RESULTS: Six students reported experiencing physical assault in the first six months of clerkship. Assaults occurred on psychiatry (4) and internal medicine (2) services. Two of the assaults took place during consultations in the emergency department. All students reported having pre-clerkship training in management of violent situations. No students were aware of PIA reporting protocols for their hospital. CONCLUSIONS: Clinical clerks are at risk of PIA during their training. Students experiencing PIA feel that current levels of pre-clerkship training do not adequately inform them of the resources available after such an incident. These findings underline the need for PIA programs in the undergraduate curriculum including preclerkship training and clear, institution-wide reporting guidelines.

Clinical Clerkship↗
PubMed2006

Clinical clerkships: students can structure their own learning.

In clinical clerkships, student learning is often unstructured and diverse. Even when curriculum objectives are explicit, they are seldom used by students to guide their learning. Student-determined learning objectives may help students to structure their learning. This study aimed to assess whether students can use this method to meet widely differing learning needs within the general practice clerkship and considered the relationship of student objectives to overall curriculum objectives. Students allocated a 5-week clerkship in general practice from April 2000 to April 2001 were required to set and meet personal learning objectives within a supportive learning environment. They recorded the strategies they used, how well objectives were met and which curriculum objectives they met. Objectives were categorised using a hierarchical system. A total of 143 (85%) students recorded 1549 objectives. Four categories accounted for 1092 (70%) of objectives: Consultation Skills; Study of Diseases; Practical Procedures, and Therapeutics. Otherwise the range of objectives set was wide, encompassing all curriculum objectives. A total of 1043 objectives were rated as satisfactorily or highly satisfactorily met and 185 (12%) were not met at all. Strategies that students used to meet objectives included clinical experience with doctors but also with practice-based nurses. Students were able to use student-determined learning objectives to meet a diverse range of learning needs within the general practice clerkship. The objectives set reflected the breadth of curriculum objectives. This method allows students to address gaps in their knowledge in a clerkship where teaching is largely based on opportunistic contact.

Clinical Clerkship↗
PubMedDate not supplied

Enhancing learning during a clinical clerkship: the value of a structured curriculum.

Third-year clerkships, organized around clinical experiences, may provide students with an uneven or narrowly focused fund of clinical knowledge. This paper describes the results of a comparative trial in which a structured curriculum, based on learning objectives, was introduced into an internal medicine clerkship at one of three teaching hospitals of a single medical school; the other two hospitals, providing similar patient care experiences, were used for comparison purposes. Students who did their clerkship at the hospital using the structured curriculum scored significantly higher on the Medicine section of the National Board Part II examination when scores were adjusted for past academic performance. The structured curriculum was very well received and, according to student perceptions, achieved the goal of expanding their basic clinical knowledge beyond that derived from reading only in connection with patient care. These results support the use of curricular guidelines and objectives as a means of enhancing students' cognitive experience during clinical clerkships.

Clinical Clerkship↗
PubMed1978

Limitations of audiovisual aids and educational objectives in a clinical clerkship.

The several components of a clinical clerkship were analyzed and correlated with Part II National Board scores and career choice. No positive correlations could be made between fulfilling educational objectives, utilization of audiovisual aids, general satisfaction and the clerkship, and eventual career choice or performance on National Board Examinations.

Attitude of Health Personnel↗
PubMed2002

Adapting the Key Features Examination for a clinical clerkship.

PURPOSE: A written test of clinical decision-making, the Key Features Examination, was developed for use in clerkship. METHODS: Following the guidelines provided by the Medical Council of Canada, a Key Features Examination was developed and implemented in an internal medicine clinical clerkship, during the 1998/99 clerkship year. The reliability and concurrent validity of the exam were assessed. RESULTS: A 2 hour examination, containing 15 key feature problems, was administered to 101 students during 6 consecutive internal medicine clerkship rotations. The reliability of the exam, calculated from Cronbach's alpha, was 0.49. The exam had modest correlation with other measures of knowledge and clinical performance. CONCLUSION: The Key Feature Examination is a feasible and reliable evaluation tool that may be implemented as a component of student assessment during a clinical clerkship.

Canada↗
PubMed1991

Clinical clerkships in neurosurgery and neurology at United States medical schools.

The neurology and neurosurgery clinical clerkship experience (excluding lectures and conferences) of the students in U.S. allopathic medical schools during one of the academic years 1986 to 1987 or 1987 to 1988 was surveyed. Almost all schools have at least some students taking these clerkships. The majority of students (78%) have clinical exposure to neurology, but only a minority (28%) take a neurosurgical clerkship; however, far more schools require their students to take neurology clerkships (54%) than neurosurgical clerkships (12%). A few require that either be taken. Overall, 81% of schools require all students to take at least one of these clerkships. For the most part, students taking a clerkship in either specialty do not do so again. The initial and usually unique exposure averages 3.5 weeks in neurology and 2.4 weeks in neurosurgery. For each specialty, required clerkships tended to be shorter than selective clerkships, which in turn were shorter than elective ones. Furthermore, first clerkships offered in the fourth year, whether they were required, selective, or elective, tended to be longer than the corresponding third-year first clerkships at other schools. Whereas the average length of a first clinical clerkship in neurology is almost as long for schools requiring it (3.4 wk) as for those that offer it as an elective or selective (4.0 wk), required neurosurgical clerkships are much shorter (1.5 wk) than elective or selective rotations (3.1 wk). Schools with residency training programs more frequently required students to a clerkship and, consequently, had greater numbers of students taking a clerkship in the corresponding specialty.(ABSTRACT TRUNCATED AT 250 WORDS)

Clinical Clerkship↗
PubMed1985

Clinical clerkships in professional education: a study in pharmacy and other ancillary professions.

An empirical study of the dynamics of clinical clerkships in professional education is offered, with particular attention to ancillary professions. For students to eventually establish innovative practices within professional organizations, they need skills in the technical aspects of their fields, as well as in role-making and interprofessional negotiation. In examining a clinical clerkship in pharmacy, it was found that faculty overwhelmingly focus on technical matters, and assume that technical competence alone is enough to attain role expansion. The experiences of students, simulating participation in a complex organization as members of clinical teams, give good reason to question this and other assumptions constituting the structure of clerkships. Several recommendations issue from the analysis for strengthening the objectives of professional training.

Clinical Clerkship↗
PubMed1992

Time allocation of students in basic clinical clerkships in a traditional curriculum.

The objective of this study was to determine the amounts of time spent in various activities by medical students enrolled in basic clinical clerkships. In the fall of 1989, 80 third-year students at the University of North Carolina at Chapel Hill School of Medicine recorded their time allocations in eight categories over 24 hours for three consecutive days. After personal time, the students spent the greatest amount of time in organized educational activities (rounds, conferences, lectures), followed in decreasing order by chartwork, patient contact, examination study, ancillary activities, procedures, and directed study. The students reported an average of 5.8 hours of sleep per night. The students reported that when they were on call, they had significant increases in patient contact, chartwork, and ancillary activities. The authors suggest that third-year students may spend too much of their time in organized educational activities, and may benefit educationally from increased amounts of patient contact and decreased amounts of ancillary activities. These data provide an opportunity for clerkship and curriculum organizers to analyze the efficacy of the basic clinical clerkships.

Adult↗