Medical students’ preparedness for professional activities in early clerkships

Abstract

BackgroundSufficient preparedness is important for transitions to workplace participation and learning in clinical settings. This study aims to analyse medical students’ preparedness for early clerkships using a three-dimensional, socio-cognitive, theory-based model of preparedness anchored in specific professional activities and their supervision level.MethodsMedical students from a competency-based undergraduate curriculum were surveyed about preparedness for 21 professional activities and level of perceived supervision during their early clerkships via an online questionnaire. Preparedness was operationalized by the three dimensions of confidence to carry out clerkship activities, being prepared through university teaching and coping with failure by seeking support. Factors influencing preparedness and perceived stress as outcomes were analysed through step-wise regression.ResultsProfessional activities carried out by the students (n = 147; 19.0%) and their supervision levels varied. While most students reported high confidence to perform the tasks, the activity-specific analysis revealed important gaps in preparation through university teaching. Students regularly searched for support in case of difficulty. One quarter of the variance of each preparedness dimension was explained by self-efficacy, supervision quality, amount of prior clerkship experience and nature of professional activities. Preparedness contributed to predicting perceived stress.ConclusionsThe applied three-dimensional concept of preparedness and the task-specific approach provided a detailed and meaningful view on medical students’ workplace participation and experiences in early clerkships.

Beyond the struggles: a scoping review on the transition to undergraduate clinical training

“…There was comparatively less research carried out from a social and developmental perspective. However, researchers are increasingly recognising a need to explore the opportunities that the transition to clinical training can provide …”

“…Included studies were from the USA (n = 21), Europe (n = 11), UK (n = 8), Canada (n = 3) and Australia (n = 2). There were 12 qualitative studies, 10,11,14,[19][20][21][22][23][24][25][26][27] 11 cross-sectional surveys, [6][7][8]13,[28][29][30][31][32][33][34] eight descriptive case studies 5,[35][36][37][38][39][40][41] (two of which were related, using the same participants and intervention), 36,37 seven longitudinal studies, [42][43][44][45][46][47][48] three descriptive comparative studies, 12,49,50 three review papers 1,3,9 and one concept paper. 51…”

“…Researchers often portrayed the transition to clinical training negatively, describing it as difficult, 6,39,50 stressful, 8,12,13,19,21,23,28,35,37,47,49 anxiety generating 8,12,13,[32][33][34]36,37 and a struggle. 7,26,27,44 Some studies started from a stance that there was a need to eliminate a variety of struggles, including students: feeling like they lacked the required knowledge and skills, 6,11,13,19,27,34 feeling unprepared, 11,28,30,32 feeling burdened by the demands of clinical training, 11,19,28,42 not meeting Box 2 Inclusion and exclusion criteria for this scoping review…”

The modular curriculum of medicine at the Charité Berlin – a project report based on an across-semester student evaluation

“…Study periods and exam results should also be included for a more complete picture. In addition, the return rates for the evaluations, which were based on voluntary participation, were comparatively low, which raises the question of representability [11]. However, evaluations based on mandatory participation carry the risk of generating improper responses.…”

“…These learning outcomes are the basis for the design of outcome-oriented curricula and the further development of existing programmes. An important measure for achieving the defined outcomes is whether students and graduates feel sufficiently prepared for the demands facing them in their working lives as a physician [10], [11]. …”