Problem Medical students typically perform worse on clinical clerkships that take place early in their training compared with those that occur later. Some institutions have developed transition-to-clerkship courses (TTCCs) to improve students’ preparedness for the clinical phase of the curriculum. Yet, the impact of TTCCs on students’ performance has not been evaluated. Approach The authors developed and implemented a TTCC at Virginia Commonwealth University School of Medicine and measured its impact on students’ clerkship performance. During the 2014–2015 academic year, they introduced a 2-week intersession TTCC. The goal was to improve students’ readiness for clerkships by fostering the knowledge, skills, and attitudes required to care for patients throughout a hospitalization. The TTCC included panel discussions, skills development sessions, case-based workshops, and a 4-station standardized patient simulation. The authors assessed the feasibility of designing and implementing the TTCC and students’ reactions and clerkship performance. Outcomes The total direct costs were $3,500. Students reacted favorably and reported improved comfort on entering clerkships. Summative performance evaluations across clerkships were higher for those students who received the TTCC with simulation compared with those students who received the standard clerkship orientation (P < .001–.04, Cohen’s d range = 0.23–0.62). This finding was particularly apparent in those clerkships that occurred earlier in the academic year. Next Steps Future plans include evaluating the impact of the TTCC on student well-being and incorporating elements of the TTCC into the preclinical curriculum.
Introduction Achieving standardized assessment of medical student competency in patient care is a challenge. Simulation may provide unique contributions to overall assessment. We developed an Internal Medicine Standardized Simulation Based Examination (SSBE) for the 3rd year clerkship to assess students’ medical knowledge, diagnostic skills, and clinical management skills. We assessed convergent and test-criterion validity by comparing the relationship of SSBE scores with USMLE Step 2 clinical knowledge, shelf exam, eQuiz, OSCE, ward evaluation scores, and overall clerkship grades. We hypothesize that use of the SSBE will allow for a more reliable assessment of these competencies and add value to existing assessments. Methods A prospective study design was used. The SSBE consisted of a computer based photo quiz and cases on high fidelity simulators. Performance on the SSBE was compared to standardized examinations, clinical evaluations, and overall clerkship grades. Students completed an evaluation of the experience. Results Two hundred seven students completed the SSBE, with a mean score of 76.69 (SD 7.78). SSBE performance was positively related to other assessments of medical knowledge (eQuiz scores (r(203) =.33, p< .01), shelf exam scores (r(158) =.53, p< .01), and clinical performance (ward scores) (r(163) =.31, p<.01) but not to OSCE scores. There was a positive relationship to final class grades (r(163) = .45, p<.01), shelf exam (r (158) =.52, p<.01) and Step 2 clinical knowledge scores (r(76) =.54, p<.01). The majority (93%) of students agreed that it was a fair exam. Conclusion Our results provide validity evidence for the SSBE as an additional assessment tool that uses a novel approach for evaluating competency in patient care at the clerkship level.
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