A feasible and acceptable logbook system is an attainable goal, although students usually did not complete logbooks unless required. The available literature does not establish that logbooks currently in use have sufficient reliability or validity to allow for the routine use of the information for program change or accreditation purposes. The ideal logbook should be inexpensive, feasible, and acceptable to students and should allow rapid collation of accurate, relevant data for timely analysis and feedback to the student and clerkship director.

Our study findings support the feasibility of this initiative as well as produced significant outcomes in terms of quantified research productivity and student mentoring.

Under ideal study circumstances, there was significant underreporting of core problems by students. Although the high specificity, meaning that students are not reporting problems they have not encountered, is reassuring, logbook sensitivity in this study was not good enough for high-stakes evaluations of students or for medical school licensing.

This SC examination was feasible and was more valid than the MCQ examination because of better correlation with clinical performance, despite being initially less reliable and less preferred by students. SC was more reliable and preferred when administered to house staff.

PURPOSE:To determine the impact of a geriatrics home visit program for third-year medical students on attitudes, skills, and knowledge.METHODS: Using a mixed methods, prospective, controlled trial, volunteer control group students (n=17) at two sites and intervention group students (n=16) at two different sites within the same internal medicine clerkship were given Internet and CDROM-based geriatric self-study materials. Intervention group students identified a geriatrics patient from their clinical experience, performed one "home" visit (home, nursing home, or rehabilitation facility) to practice geriatric assessment skills, wrote a structured, reflective paper, and presented their findings in small-group teaching settings. Papers were qualitatively analyzed using the constant comparative method for themes. All students took a pre-test and post-test to measure changes in geriatrics knowledge and attitudes.RESULTS: General attitudes towards caring for the elderly improved more in the intervention group than in the control group (9.8 vs 0.5%; p=0.04, effect size 0.78). Medical student attitudes towards their home care training in medical school (21.7 vs 3.2%; p=0.02, effect size 0.94) improved, as did attitudes towards time and reimbursement issues surrounding home visits (10.1 vs −0.2%; p = 0.02, effect size 0.89). Knowledge of geriatrics improved in both groups (13.4 vs 15.2% improvement; p=0.73). Students described performing a mean of seven separate geriatric assessments (range 4-13) during the home visit. Themes that emerged from the qualitative analysis of the reflective papers added depth and understanding to the quantitative data and supported results concerning attitudinal change.CONCLUSIONS: While all participants gained geriatrics knowledge during their internal medicine clerkship, students who performed a home visit had improved attitudes towards the elderly and described performing geriatric assessment skills. Requiring little faculty time, a geriatrics home visit program like this one may be a useful clerkship addition to foster medical students' professional growth.

A qualitative study to describe the barriers to and solutions for recruiting physicians to teach students in ambulatory settings is planned. Other studies will evaluate the effectiveness of faculty development efforts and the impact of students' presence on patients' access to clinic appointments.

This intervention was effective in improving providers' compliance with a hypertension practice guideline, but only when led by a faculty opinion leader. A resident instructor using the same format was unable to change the providers' behaviors.

2016-11-03T14:11:40