J Educ Eval Health Prof.  2020;17:17. 10.3352/jeehp.2020.17.17.

Voluntary assignments during the pediatric clerkship to enhance the clinical experiences of medical students in the United States

• Krawiec C
• Myers AK

• KMID: 2504424
• DOI: http://doi.org/10.3352/jeehp.2020.17.17

Abstract

Purpose
Pediatric clerkships that utilize off-campus clinical sites ensure clinical comparability by requiring completion of patient-focused tasks. Some tasks may not be attainable (especially off-campus); thus, they are not assigned. The objective of this study was to evaluate the feasibility of providing a voluntary assignment list to third-year medical students in their pediatric clerkship.
Methods
This is a retrospective single-center cross-sectional analysis of voluntary assignment completion during the 2019–2020 academic year. Third-year medical students were provided a voluntary assignment list (observe a procedure, use an interpreter phone to obtain a pediatric history, ask a preceptor to critique a clinical note, and follow-up on a patient after the rotation ends). Descriptive statistics were used to assess the timing and distribution of voluntary assignment completion.
Results
In total, 132 subjects (77 on the main campus, 55 off-campus) were included. Eighteen (13.6%) main-campus and 16 (12.1%) off-campus students completed at least 1 voluntary assignment. The following voluntary assignments were completed: observe a procedure (15, 11.4%), use an interpreter phone (26, 19.7%), ask a preceptor to critique a clinical note (12, 9.1%), and follow-up on a patient after the rotation ends (7, 5.3%). Off-campus students completed the assignments more often (29.1%) than on-campus students (23.4%)
Conclusion
Our clerkship values specific patient-focused tasks that may enhance student development, but are not attainable at all clinical sites. When provided a voluntary assignment list, 34 out of 132 students (25.8%) completed them. Clerkships that utilize off-campus sites should consider this approach to optimize the pediatric educational experience.

Keyword

Educational measurement; Educational technology; Educational methods; Medical education

Figure

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  Fig. 1. Voluntary assignment completion rate per 4-week pediatric clerkship rotation.

Reference

References

1. Wright HM, Maley MAL, Playford DE, Nicol P, Evans SF. Paediatric case mix in a rural clinical school is relevant to future practice. BMC Med Educ. 2017; 17:237. https://doi.org/10.1186/s12909-017-1082-1.

2. Schuttpelz-Brauns K, Narciss E, Schneyinck C, Bohme K, Brustle P, Mau-Holzmann U, Lammerding-Koeppel M, Obertacke U. Twelve tips for successfully implementing logbooks in clinical training. Med Teach. 2016; 38:564–569. https://doi.org/10.3109/0142159X.2015.1132830.

3. Langenau EE, Lee R, Fults M. Blended learning educational format for third-year pediatrics clinical rotation. J Am Osteopath Assoc. 2017; 117:234–243. https://doi.org/10.7556/jaoa.2017.041.

4. Chen JG, Saidi A, Rivkees S, Black NP. University- versus community-based residency programs: does the distinction matter? J Grad Med Educ. 2017; 9:426–429. https://doi.org/10.4300/JGME-D-16-00579.1.

5. Ryan MS, Leggio LE, Peltier CB, Chatterjee A, Arenberg S, Byerley JS, Belkowitz JL, Rabalais GP, Barone MA. Recruitment and retention of community preceptors. Pediatrics. 2018; 142:e20180673. https://doi.org/10.1542/peds.2018-0673.

6. Park EW. Comparison of medical students’ satisfaction with family medicine clerkships between university hospitals and community hospitals or clinics. Korean J Fam Med. 2016; 37:340–345. https://doi.org/10.4082/kjfm.2016.37.6.340.

7. De Villiers M, van Schalkwyk S, Blitz J, Couper I, Moodley K, Talib Z, Young T. Decentralised training for medical students: a scoping review. BMC Med Educ. 2017; 17:196. https://doi.org/10.1186/s12909-017-1050-9.

8. Foster JH, Byerley J, Tarantino H, Chuang A, Pino J, Latessa R, Nagappan S, Monroe R, Gilliland K, Steiner B, Beck Dallaghan GL. Cracking the Nut on LCME Standard 8.7: innovations to ensure comparability across geographically distributed campuses. Teach Learn Med. 2019; 31:544–551. https://doi.org/10.1080/10401334.2019.1609966.

9. Fielder EK, Lemke DS, Doughty CB, Hsu DC, Middleman AB. Development and assessment of a pediatric emergency medicine simulation and skills rotation: meeting the demands of a large pediatric clerkship. Med Educ Online. 2015; 20:29618. https://doi.org/10.3402/meo.v20.29618.

10. Stroh DA, Ray-Mazumder N, Norman JA, Haider AH, Stevens KA, Chi A, Rushing AP, Efron DT, Haut ER. Influencing medical student education via a voluntary shadowing program for trauma and acute care surgery. JAMA Surg. 2013; 148:968–970. https://doi.org/10.1001/jamasurg.2013.363.

11. Ekenze SO, Obi UM. Perception of undergraduate pediatric surgery clerkship in a developing country. J Surg Educ. 2014; 71:560–566. https://doi.org/10.1016/j.jsurg.2013.11.010.

12. Rodriguez F, Cohen A, Betancourt JR, Green AR. Evaluation of medical student self-rated preparedness to care for limited English proficiency patients. BMC Med Educ. 2011; 11:26. https://doi.org/10.1186/1472-6920-11-26.

13. Vargas Pelaez AF, Ramirez SI, Valdes Sanchez C, Piedra Abusharar S, Romeu JC, Carmichael C, Bascoy S, Baron R, Pichardo-Lowden A, Albarracin N, Jones CC, Silveyra P. Implementing a medical student interpreter training program as a strategy to developing humanism. BMC Med Educ. 2018; 18:141. https://doi.org/10.1186/s12909-018-1254-7.

14. Raymond BL, Fowler LC, Robertson AC. The impact of converting from an ‘educator-driven’ to a ‘learner-initiated’ feedback model. J Educ Perioper Med. 2019; 21:E627.

15. Hom J, Richman I, Chen JH, Singh B, Crump C, Chi J. Fulfilling outpatient medicine responsibilities during internal medicine residency: a quantitative study of housestaff participation with between visit tasks. BMC Med Educ. 2016; 16:139. https://doi.org/10.1186/s12909-016-0665-6.