Third year medical students (n=26) participated in a pilot program of an entirely outpatient multispecialty clinic experience. Overall, 61 percent of outpatient encounters involved a surgical diagnosis currently managed entirely on an outpatient basis, illustrating the importance of this setting in broad student exposure to surgery and surgical…

Studies in five senior medical school classes at Southern Illinois University investigated whether using multiple standardized patients to simulate the same case in postclerkship medical student evaluation affects the measure's reliability. Results of three studies show little or no effect on reliability of total, checklist, or written test…

A University of Adelaide (Australia) study investigated the effect of administering identical stations to different classes over a 12-year period within the objective structured clinical examination component of a final-year medical school examination. Repeat administrations correlated with improved student performance over time. (Author/MSE)

Four years of experience with an objective structured clinical examination (OSCE) following an eight-week surgical clerkship (n=356 students) are reported, including data on mean student performance across years, reliability coefficients, and generalizability. Implications for improvement and development of OSCE are discussed. (Author/MSE)

A study using five Southern Illinois University senior medical school classes (n=350 students) investigated whether having a standardized patient simulate a case repeatedly in postclerkship medical student evaluation affects the measure's reliability. Results suggest that repeated simulation had little or no effect on intercase reliability of…

Analysis of 61 inpatient medical writeups by 23 third year medicine clerks found smoking history notations in 74 percent but quantification of exposure much less commonly. None detailed patient addiction or willingness to quit, or included smoking cessation in the patient plan. Students' smoking assessment and cessation skills are seen as poorly…

Evaluators in six objective structured clinical examinations were encouraged to add written comments to the traditional checklist rating forms. The 1,283 comments were categorized as trainee performance (technique, content, summary) and organizational comments. Analysis found that the comments were relevant and useful, and provided substantial…

A description of the development of a new surgery clerkship looks at institutional background (University of Kentucky College of Medicine) for the project, preliminary evaluation and planning efforts, formulation of an ideal for the clerkship, barriers to change, overcoming resistance to change, and comparisons with problem-based learning programs…

In cases where private medical practitioners volunteer as preceptors in medical clerkships, standardizing and evaluating the learning experience is a concern. A study investigated the effectiveness of feedback to the volunteer teachers as a means of improving instruction in identified deficiency areas. Results indicate some problems persist.…

A study identified variables perceived by clinical medical faculty (n=20) to influence the ease or difficulty of teaching in the ambulatory care setting. Characteristics affecting the teaching situation included teacher, student, and patient characteristics. Implications for faculty development on teaching in the clinical setting are discussed.…

Strategies used at several medical schools to address common issues in ambulatory care clerkship programs are presented. These include institutional and policy concerns (institutional resistance, financing, faculty incentives), administrative and implementation problems (logistics, faculty recruitment, student recruitment/placement), and…

The Medical College of Georgia's third-year medicine clerkship includes a one-month ambulatory care block rotation in internal medicine, medicine, and dermatology. Students present topics and participate in case discussions in daily and weekly conferences. Program success is resulting in expansion. (MSE)

The ambulatory care segment of the Southern Illinois University internal medicine clerkship provides extensive clinical exposure in a variety of settings and includes formal educational activities in seminars and workshops. Despite problems, educational quality has improved. Planned expansion includes a longitudinal experience for students.…

The University of Manitoba (Canada) medical school is introducing teaching in the ambulatory care setting as traditional inpatient wards become less suitable for clerkships. However, few faculty are willing to accommodate students in their clinics, and other educational and administrative difficulties impede program expansion. (MSE)

A one-month subspecialty outpatient clinic program for third-year medical students is described. The clerkship featured high volume (60-70 patients) clinical practice, library research (12 short papers), and close mentor supervision. Pre- and posttest scores did not distinguish participants from others, but participants later reported improved…