Starting learning in medical practice: an evaluation of a new Introductory clerkship

Abstract

The transition from undergraduate medical education to learning in clinical clerkships can be difficult for students. Learning in clinical practice requires awareness of learning opportunities and goals, active elaboration and reflection. Staff should provide students with guidance to learn from their experiences. A new Introductory Clerkship was designed to facilitate the start of goal-oriented, active and reflective work-based learning. This four-week clerkship is a result of the cooperation of six major specialties in the university hospital. The innovations included explicitly formulated goals, a description of the student's activities in daily practice and of the staff's role, group meetings, a logbook, a halfway formative interview and a final summative interview. The aim of this study was to investigate to what extent the innovations of the new Introductory Clerkship were implemented and how students and residents valued them. Two questionnaires were constructed: one was administered to students (n = 54) and the other to residents (n = 27). Students considered participation in daily practice very instructive, although more observations of history taking and physical examination are wanted. The interviews and group meetings promote students' learning. Use of the logbook needs improvement. Residents perceived a shortage of time and would appreciate more participation of staff members, as well as a better preparation for supervising tasks. Overall, the study demonstrates that it is possible to introduce innovations in clinical clerkships to improve the learning environment of work-based learning.

Outcome (competency) based education: an exploration of its origins, theoretical basis, and empirical evidence

“…In other studies, learning outcomes were part of complex curriculum interventions, which made it hard to determine their independent contribution. These studies showed increases in students' self-evaluated competence and confidence (Brody et al 2003;Jacobs et al 2005;Lai and Ramesh 2006). There was one important, negative finding from a study, which asked students how they used course objectives, exam blueprints, and the content of teaching sessions for examination preparation (McLaughlin et al 2005).…”

Transition to Clerkship Courses: Preparing Students to Enter the Workplace

“…Although helpful in some respects, 4 these efforts have not completely mitigated the challenges students face entering clerkships. [5][6][7][8] Both students and clerkship directors report deficiencies at the start of the clerkships due to insufficient opportunities for students to practice clinical skills and/or the students' difficulty using these skills in real time with real patients. 2,3,9 Therefore, many schools have developed courses, sessions, or orientations that take place immediately prior to the first clerkship to facilitate this transition; however, as evidenced by a qualitative content analysis showing that these courses vary considerably in their structure, content, and educational strategies, 10 no model or framework seems to guide their design.…”

Hidden benefits of a peer-mentored ‘Hospital Orientation Day’: First-year medical students’ perspectives

“…The 'learning trajectory' in the transition from Medical Student to physician has many stages (Slotnick 2001) and the HOD provided valuable insight into this process, helping to calm the uncertainty amongst many of the students. Students reported that the HOD made them feel more comfortable about future clinical placements, an outcome that has also been found using other forms of ECE (Jacobs et al 2005). The HOD has a limited role in reducing the stress of entering the hospital environment but may have a major role in reducing stress from the uncertainty of what lies ahead.…”