A study investigated the relationships among nine instruments designed to measure clinical knowledge and performance in a third-year surgery clerkship. Results suggest that various types of measures are necessary for broad evaluation of clinical performance. Instruments clustered into two groups: measures of medical knowledge and clinical…

An innovative internal medicine clerkship provides a one-month ambulatory care component followed by two months of traditional inpatient experience. Assessment of the changes in student ability to diagnose in a variety of brief cases found knowledge gains in the shorter ambulatory care segment were double those in the longer segment. (MSE)

A study of 184 third-year medical students randomly assigned to ambulatory care and traditional inpatient curricula in an internal medicine clerkship found those with the ambulatory care experience were somewhat more likely to choose an ambulatory care career than those in the traditional curriculum. However, the clerkship experience did not…

In a pilot study, two methods of identifying problems in the evaluation of third- and fourth-year medical students' clinical skills were tested. The two types of materials, questionnaires and a problem-case analysis, were found to be complementary, both identifying some of the same problems and each identifying some different problems. (MSE)

The University of Chicago Pritzker School of Medicine has developed a teaching program in clinical ethics which utilizes the clinical knowledge and teaching skills of housestaff and clinical faculty. A detailed table summarizes the four-year curriculum including number of hours each year, teaching methods, sample topics, and principal faculty.…

Emergency medicine residents at William Beaumont Hospital are evaluated quarterly by the nursing staff. The nurses discuss each resident and reach consensus on each evaluation item and copies are given to each resident. Although the residents' attitudes have not been favorable, overall their behavioral interactions have improved markedly.…

In standardized patient-based tests of clinical competence, patients are used to present the clinical problem and to rate the actions taken by the student. This approach is evaluated by a microanalysis of 1 case used in a fourth year clinical examination of 98 medical students at the University of Manitoba. (MLW)

Interrater reliability in numerical ratings of clerkship performance (n=1,482 students) in five surgery programs was studied. Raters were classified as accurate or moderately or significantly stringent or lenient. Results indicate that increasing the proportion of accurate raters would substantially improve the precision of class rankings. (MSE)

Discusses the role of departments of family medicine in teaching preventive medicine through required clinical experiences, required nonclinical courses, electives, collaborative interdisciplinary clerkships, and interdisciplinary nonclinical courses. Offers examples of innovative programs at the Universities of Michigan, Wisconsin, Vermont,…

The Medical College of Pennsylvania uses outstanding senior students as teaching assistants for sophomore students needing additional observation and feedback to increase clinical skills. The seniors are less threatening than faculty and may give more effective feedback. Both student groups are satisfied with the program. (MSE)

Computer-based clinical simulations used in medical education are designed according to decisions about which elements of reality to explicitly include, which to leave to imagination, and when to intervene for educational purposes. Programs offer many options for structuring the simulations, such as varying levels of volunteered information about…

An Oregon program is described in which physicians in training are incorporated into a faculty private practice clinic. The model encourages efficiency, overhead control, and appropriate staffing; it also provides a useful learning experience in the ambulatory care setting and compensates faculty members for their additional time spent teaching.…

This survey of 67 university and 172 nonuniversity teaching hospitals in Japan found that many of the residents, especially in the university hospitals, received no experience in basic clinical skills during their 2-year residencies. Possible explanations for this lack are offered, and the need for improved training in basic clinical skills is…

A remedial program was designed for Oregon Health Sciences University clerkship students demonstrating adequate clinical skills but inadequate knowledge. In two years, six students were enrolled in the tutorial program. The experience was highly successful for all but one. Participants saw it as one of their best medical school experiences.…

Analysis of data from an annual graduating medical students' survey revealed that a required third-year family medicine clerkship of at least four weeks is associated with a higher percentage of students choosing training and specialty certification in family practice. Whether clerkship inspires or reinforces preexisting choices is not indicated.…