Consequences of shifting medical-student education to the outpatient setting: Effects on performance and experiences
Department of Internal Medicine, University of Michigan Medical Center, Ann Arbor 48109-0368, USA. Academic Medicine
(Impact Factor: 2.93).
02/1996; 71(1 Suppl):S99-101. DOI: 10.1097/00001888-199601000-00056
Available from: depts.washington.edu
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ABSTRACT: To compare the performance of third-year medical students who completed the ambulatory component of their pediatric rotation in a community setting with the performance of third-year medical students who had their ambulatory experience on campus.
As part of a pilot project to implement a third-year Multidisciplinary Ambulatory Clerkship, 61 third-year medical students spent 12 weeks rotating through the primary care disciplines of family medicine, internal medicine, and pediatric practitioners' offices at sites distant from the university campus while 127 students remained on campus for their ambulatory experiences in these disciplines. The components of the overall pediatric grade consisted of a clinical performance evaluation in the ambulatory setting (4 weeks), a clinical performance evaluation on a 4-week inpatient rotation, and a grade from a multiple-choice final examination.
The overall mean+/-SD final pediatric grade of students receiving their ambulatory pediatrics experience in the Multidisciplinary Ambulatory Clerkship was 86.5+/-3.4 compared with 88.0+/-3.4 for students receiving their ambulatory experience on campus (P<.007). This difference was accounted for by performance on the written final examination. Multidisciplinary Ambulatory Clerkship students had a mean+/-SD score of 78.9+/-8.3 and a failure rate of 18% compared with a mean score of 83.7+/-8.1 and failure rate of 3.9% for students who remained on campus for their ambulatory experience (P<.001 for both comparisons). No differences were noted between the 2 groups on their clinical performance evaluations for their ambulatory or inpatient experiences.
These data suggest a difference in the learning experience between students receiving their pediatric ambulatory experience in the community vs on campus. Differences in exposure to structured learning experiences that occurred more frequently on campus might account for some of the difference in final examination results. Development of a standardized, structured learning experience across community sites would seem to be an appropriate means of enhancing learning in the community setting.
Available from: David Musick
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ABSTRACT: : "Educational policy analysis" is a formal discipline that has not been widely used in medical education. A review of literature shows that the lack of policy analysis "tools" results in an approach to educational policy analysis and/or development that may be fragmented and unorganized. This paper describes a twelve step, explicit approach to policy analysis within medical schools. An example of how to use this approach is included. Adoption of this method of policy will result in a more explicit and formal approach to curricular governance and educational decision-making within medical schools. "Policy analysis" is a formal discipline within the field of education; its prominence is evidenced most recently by the establishment of a special division (Division L, "Educational Policy and Politics") within the American Educational Research Association 1 which is devoted to the stimulation of "informed and systematic debate, analysis, research, evaluation and recommendations co...
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