A randomized, controlled pilot study of placing third-year medical clerks in a continuity clinic. 1993

M A Papadakis, and M K Kagawa
Department of Medicine, University of California, School of Medicine, San Francisco.

BACKGROUND Because of the great interest in developing ambulatory care components within medical school curricula, there is a need for outcome data concerning such changes. METHODS In 1991-92, 40 third-year students at the University of California, San Francisco, School of Medicine were assigned to the San Francisco Veterans Affairs Medical Center for their core medicine clerkships; ten of these students were exposed to ambulatory care by being assigned to medical residents who worked in a general medicine continuity clinic. The ten students in the continuity clinic and the 30 who were not were evaluated by means of their (1) final clerkship evaluation scores for overall competence, (2) performances on a standardized-patient exercise where the majority of the simulations were of ambulatory care problems, and (3) self-assessment of clinical skills and knowledge and attitudes about primary care. Student's t-test was used to determine whether there were statistically significant differences between the performances of the two groups. In addition, the students in the clinic kept diaries about their clinic experiences. RESULTS No significant difference was found between the two groups of students on the objective or subjective measures of evaluation, although the diary narratives of the clinic students revealed that they were extremely enthusiastic about the clinic experience. CONCLUSIONS Because there was no significant difference between the performances of the two student groups, the ambulatory care model in this study, despite its feasibility to implement, was not adequate to teach the students the different problem-solving and therapeutic skills necessary in the ambulatory care setting.

UI MeSH Term Description Entries
D007388 Internal Medicine A medical specialty concerned with the diagnosis and treatment of diseases of the internal organ systems of adults. General Internal Medicine,Medicine, Internal,Internal Medicine, General,Medicine, General Internal
D007396 Internship and Residency Programs of EDUCATION, MEDICAL, GRADUATE training to meet the requirements established by accrediting authorities. House Staff,Internship, Dental,Residency, Dental,Residency, Medical,Dental Internship,Dental Internships,Dental Residencies,Dental Residency,Internship,Internship, Medical,Internships, Dental,Medical Residencies,Medical Residency,Residencies, Dental,Residencies, Medical,Residency,Residency and Internship,Internships, Medical,Medical Internship,Medical Internships,Residencies,Staff, House
D007722 Health Knowledge, Attitudes, Practice Knowledge, attitudes, and associated behaviors which pertain to health-related topics such as PATHOLOGIC PROCESSES or diseases, their prevention, and treatment. This term refers to non-health workers and health workers (HEALTH PERSONNEL). Knowledge, Attitudes, Practice
D008297 Male Males
D010044 Outpatient Clinics, Hospital Organized services in a hospital which provide medical care on an outpatient basis. Ambulatory Care Facilities, Hospital,Hospital Outpatient Clinics,Clinic, Hospital Outpatient,Clinics, Hospital Outpatient,Hospital Outpatient Clinic,Outpatient Clinic, Hospital
D010865 Pilot Projects Small-scale tests of methods and procedures to be used on a larger scale if the pilot study demonstrates that these methods and procedures can work. Pilot Studies,Pilot Study,Pilot Project,Project, Pilot,Projects, Pilot,Studies, Pilot,Study, Pilot
D011231 Preceptorship Practical experience in medical and health-related services that occurs as part of an educational program wherein the professionally-trained student works outside the academic environment under the SUPERVISION of an established professional in the particular field. Clinical Mentoring,Clinical Supervision,Clinical Practicum,Field Study, Medical,Field Training, Medical,Field Work, Medical,Clinical Mentorings,Clinical Supervisions,Field Studies, Medical,Medical Field Studies,Medical Field Study,Medical Field Training,Medical Field Work,Mentoring, Clinical,Mentorings, Clinical,Practicum, Clinical,Practicums, Clinical,Studies, Medical Field,Study, Medical Field,Supervision, Clinical,Supervisions, Clinical,Training, Medical Field,Work, Medical Field
D011320 Primary Health Care Care which provides integrated, accessible health care services by clinicians who are accountable for addressing a large majority of personal health care needs, developing a sustained partnership with patients, and practicing in the context of family and community. (JAMA 1995;273(3):192) Primary Care,Primary Healthcare,Care, Primary,Care, Primary Health,Health Care, Primary,Healthcare, Primary
D002982 Clinical Clerkship Undergraduate education programs for second- , third- , and fourth-year students in health sciences in which the students receive clinical training and experience in teaching hospitals or affiliated health centers. Clerkship, Clinical,Clerkships, Clinical,Clinical Apprenticeship,Clinical Clerkships,Apprenticeship, Clinical,Apprenticeships, Clinical,Clinical Apprenticeships
D005260 Female Females

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