Impact of family medicine clerkships in undergraduate medical education: a systematic review

Abstract

ObjectiveSynthesise evidence about the impact of family medicine/general practice (FM) clerkships on undergraduate medical students, teaching general/family practitioners (FPs) and/or their patients.Data sourcesMedline, ERIC, PsycINFO, EMBASE and Web of Knowledge searched from 21 November to 17 December 2013. Primary, empirical, quantitative or qualitative studies, since 1990, with abstracts included. No country restrictions. Full text languages: English, French, Spanish, German, Dutch or Italian.Review methodsIndependent selection and data extraction by two authors using predefined data extraction fields, including Kirkpatrick’s levels for educational intervention outcomes, study quality indicators and Best Evidence Medical Education (BEME) strength of findings’ grades. Descriptive narrative synthesis applied.ResultsSixty-four included articles: impact on students (48), teaching FPs (12) and patients (8). Sample sizes: 16-1095 students, 3-146 FPs and 94-2550 patients. Twenty-six studies evaluated at Kirkpatrick level 1, 26 at level 2 and 6 at level 3. Only one study achieved BEME’s grade 5. The majority was assessed as grade 4 (27) and 3 (33). Students reported satisfaction with content and process of teaching as well as learning in FM clerkships. They enhanced previous learning, and provided unique learning on dealing with common acute and chronic conditions, health maintenance, disease prevention, communication and problem-solving skills. Students’ attitudes towards FM were improved, but new or enhanced interest in FM careers did not persist without change after graduation. Teaching FPs reported increased job satisfaction and stimulation for professional development, but also increased workload and less productivity, depending on the setting. Overall, student’s presence and participation did not have a negative impact on patients.ConclusionsResearch quality on the impact of FM clerkships is still limited, yet across different settings and countries, positive impact is reported on students, FPs and patients. Future studies should involve different stakeholders, medical schools and countries, and use standardised and validated evaluation tools.

Health Literacy amongst Health Professional University Students: A Study Using the Health Literacy Questionnaire

“…This is obviously an area which needs further attention. Potentially, one of the ways this issue could be addressed is by including clinical placement opportunities earlier in the health degree programs [42] and including community health placements as a component of these earlier placements [43][44][45]. Another possible solution would be to pair students with patient volunteers from diverse backgrounds, who have serious or chronic medical conditions, an approach used in the Family Centre Experience [46].…”

Improving outcomes in adults with diabetes through an interprofessional collaborative practice program

“…Participating staff included physicians, nurses, dieticians, community health workers, medical assistants, and a scheduler. The team carefully considered the potential impact of the students on preceptors' efficiency in the primary care setting, as one systematic review found that although students improved job satisfaction, they negatively impacted preceptor workload and productivity (Turkeshi, Michels, Hendrickx, & Remmen, 2015).…”

Pilot phase evaluation of the elective general practice class: results of student surveys of the first two years

“…Currently ongoing international studies show that, in spite of positive educational benefits, even elaborately designed and realised curricular interventions have less influence upon the choice of medical specialty and the location of a practice than personal “practical experiences” [16], [17]. Accordingly, mentors are an indispensable part of similar projects [7], [8] and are particularly recommended for sitting in on lectures in the early phases of study, for which both students and mentors must however be prepared [6], [18], [19].…”