Perceptions and Attributions of Third-Year Student Struggles in Clerkships: Do Students and Clerkship Directors Agree?
Academic MedicinePublished 1 October 2007
Bridget C. OʼBrien, Molly Cooke, David M. Irby
Citations188
SJR quartileQ1
SJR score1.45
SNIP2.03
Generate an AI Snapshot to get a quick, structured summary of this paper.
Study Snapshot
ObjectiveStudy objective
MethodsResearch methodology
PopulationPopulation studied
Sample sizeSample sizes
OutcomesStudy outcomes here
ResultsStudy results comes here
LimitationsResearch study limitations comes here
A concise AI-generated summary of the paper will appear here once you click Generate AI Snapshot.
TL;DR
The congruence between students' and clerkship directors' perceptions and attributions of students' struggles during the transition to clerkships is explored to suggest that these challenges may be more complex than clerkships directors and clinical teachers realize and/or are capable of addressing.
Abstract
Clerkship directors and students recognize many challenges associated with learning and performing in the clerkships. Students' perspectives suggest that these challenges may be more complex than clerkship directors and clinical teachers realize and/or are capable of addressing. The areas in which clerkship directors' and students' perspectives are not congruent point to directions for future research that can guide curricula and teaching strategies.
Keywords
Medicine
ManSituated Learning: Legitimate Peripheral Participation.
39,763 Citations1994Maurice Bloch, Jean Lave +1 more
How people learn: Brain, mind, experience, and school.
12,897 Citations1999John D. Bransford, Ann L. Brown +1 more
Bibliothèque et Archives nationales du Québec (Québec government)Educating the reflective practitioner
11,390 Citations1987Donald A. Schön
Building on the concepts of professional competence that he introduced in his classic The Reflective Practitioner, Schon offers an approach for educating professional in all areas that will prepare them to handle the complex and unpredictable problems of actual practice with confidence, skill, and care.
IEEE ExpertMind over Machine: The Power of Human Intuition and Expertise in the Era of the Computer
3,179 Citations1987Hubert L. Dreyfus, Stuart E. Dreyfus +1 more
The authors, one a philosopher and the other a computer scientist, argue that even highly advanced systems only correspond to the very early stages of human learning and that there are many human skills that computers will never be able to emulate.
Academic MedicineA cognitive perspective on medical expertise
1,117 Citations1990Henk G. Schmidt, Gina Norman +1 more
A new theory of the development of expertise in medicine is outlined, which assumes that expertise is not so much a matter of superior reasoning skills or in-depth knowledge of pathophysiological states as it is based on cognitive structures that describe the features of prototypical or even actual patients.
Academic MedicineSelf-Assessment in the Health Professions: A Reformulation and Research Agenda
930 Citations2005Kevin W. Eva, Glenn Regehr
A large number of studies of self-assessment ability in medical education, health professional education, and professions educat have identified self-Assessment as a vital aspect of professional self-regulation.
Health AffairsGeneral Competencies And Accreditation In Graduate Medical Education
738 Citations2002Paul B. Batalden, David C. Leach +3 more
The Accreditation Council for Graduate Medical Education decided to specify six general competencies of graduate medical education: patient care; medical knowledge; practice-based learning and improvement; professionalism; interpersonal skills and communication; and systems-based practice.
Medical EducationPerceived stress during undergraduate medical training: a qualitative study
565 Citations2003Christina Radcliffe, Helen Lester
This qualitative study explores the views of Year 5 medical students on the causes of stress throughout their undergraduate medical training.
Cognitive ScienceOn the Role of Biomedical Knowledge in Clinical Reasoning by Experts, Intermediates and Novices
541 Citations1992Henny P. A. Boshuizen, Henk G. Schmidt
It was shown that experts have more in-depth biomedical knowledge than novices and subjects at intermediate levels of expertise and generally support a three-stage model of expertise development in medicine consisting of acquisition of biomedical knowledge, practical experience, and integration of theoretical and experientall knowledge resulting in knowledge encapsulation.
New England Journal of Medicine“Continuity” as an Organizing Principle for Clinical Education Reform
517 Citations2007David A. Hirsh, Barbara Ogur +2 more
This article which concludes the medical education series, presents evidence and musters arguments for longitudinal integration of the medical curriculum, and concludes that the traditional approach to clinical education has involved a series of rotations in various clinical settings.
Academic MedicineDo clinical clerks suffer ethical erosion? Studentsʼ perceptions of their ethical environment and personal development
488 Citations1994C Feudtner, Dimitri Christakis +1 more
The ethical dilemmas that medical students perceive as affecting them while serving as clinical clerks are apparently common and often detrimental, and warrant the attention of physicians, educators, and ethicists.
Academic MedicineWhat clinical teachers in medicine need to know
435 Citations1994David M. Irby
The author carried out a qualitative study of six distinguished clinical teachers in general internal medicine in 1991, and identified six domains of knowledge essential to teaching excellence in the context of teaching rounds: clinical knowledge of medicine, patients, and the contexts of practice, as well as educational knowledge of learners, general principles of teaching and case-based teaching scripts.
How Doctors Think: Clinical Judgment and the Practice of Medicine
433 Citations2005Kathryn Montgomery
R rationality in an uncertain practice and some rules of clinical reasoning, and the use and misuse of the science claim.
Academic MedicineStress, coping, and well-being among third-year medical students
360 Citations1994Thomas H. Mosley, Sean Perrin +4 more
Because students who employed coping efforts characterized by Engagement strategies suffered from fewer depressive symptoms, the results suggest that training in these types of strategies may be a useful intervention to lessen the negative consequences of stress among medical students.
BMJEarly practical experience and the social responsiveness of clinical education: systematic review
353 Citations2005Sonia Littlewood, Valmae Ypinazar +4 more
Academic MedicineFaculty and the Observation of Trainees’ Clinical Skills: Problems and Opportunities
331 Citations2004Eric S. Holmboe
The author outlines the nature of the problems in clinical skills and their evaluation by faculty and ends with recommendations to improve the current state of faculty skills in evaluation.
Medical EducationStudents' opinions about their preparation for clinical practice
303 Citations2005Katinka J.A.H. Prince, Henny P. A. Boshuizen +2 more
Data suggest that medical students do not feel sufficiently prepared for clinical practice in the clerkships, and the transition from pre‐clinical to clinical training causes problems.
Professional Learning: Gaps and Transitions on the Way from Novice to Expert
259 Citations2004Henny P. A. Boshuizen, Rainer Bromme +1 more
BMJWhat can experience add to early medical education? Consensus survey
239 Citations2004Tim Dornan, Christine Bundy
A rationale for early experience would be to strengthen and deepen cognitively, broaden affectively, contextualise, and integrate medical education, which is partly a process of professional socialisation that should start earlier to avoid an abrupt transition.
Academic MedicineSemantic structures and diagnostic thinking of experts and novices
225 Citations1991Georges Bordage, Marie‐Claude Lemieux
Journal of General Internal MedicineSupporting the moral development of medical students
217 Citations2000William T. Branch
Educational interventions that positively influence this process have established regular opportunities for critical reflection by the students in small groups and include faculty development to enhance role modeling and feedback by clinical faculty.
Advances in Health Sciences EducationA Qualitative Analysis of the Transition from Theory to Practice in Undergraduate Training in a PBL-Medical School
195 Citations2000Katinka J.A.H. Prince, Margaretha van de Wiel +3 more
To facilitate the transition from theory to practice in the Maastricht Medical School some curricular changes could be introduced, such as early patient contacts to motivate students and help them learn usable knowledge.
Educational ResearcherTransitions and Trajectories for Studies of Expertise
173 Citations2003Susanne P. Lajoie
Medical EducationStrategic planning in medical education: enhancing the learning environment for students in clinical settings
166 Citations2000Jill Gordon, Clarke B. Hazlett +7 more
The 1999 Cambridge Conference was held in Northern Queensland, Australia, on the theme of clinical teaching and learning and provided an opportunity for groups of academic medical educators to consider some of the challenges posed by recent changes to health care delivery and medical education.
Medical EducationClinical students' initial reports of the educational climate in a single medical school
160 Citations2004Mary Seabrook
The educational climate (the environment perceived by students) at a single medical school is explored to focus on the perceptions of students in the early stages of their clinical course.
Medical EducationContextual tensions of the clinical environment and their influence on teaching and learning
156 Citations2004Kimberly Hoffman, Joe F. Donaldson
Clinical teaching in academic medical centres is facing major challenges, and finding creative, effective strategies to support patient care and teaching are critical for survival.
Medical TeacherProfessional socialization revised: medical students' own conceptions related to adoption of the future physician's role--a qualitative study
153 Citations2003Kaisu Pitkälä, Taina Mäntyranta
Self-image as a future doctor rapidly evolved during patient contacts in the first clinical year and medical students felt lacking in credibility in front of their patients but towards the end they enjoyed their role as student-physicians.
Medical EducationThe rise and fall of students' skill in obtaining a medical history
146 Citations1998Carol Pfeiffer, Heather Madray +2 more
Results show that students' development of skills differed, with closure items show the greatest increase and social history items showing the greatest decline, with an overall initial increase and then a decline in interviewing skills over the four years.
Medical EducationAn evaluation study of the didactic quality of clerkships
145 Citations2000Roy Remmen, Joke Denekens +5 more
Previous qualitative research at the University of Antwerp revealed dissatisfaction amongst medical students about clinical clerkships, and this research aims to address this dissatisfaction.
Advances in Health Sciences EducationSmoothing Out Transitions: How Pedagogy Influences Medical Students’ Achievement of Self-regulated Learning Goals
143 Citations2006Casey White
Self-regulated learning can help smooth out the transitions through medical school by preparing first and second year students for expectations in the third and fourth years, which can then maximize learning in the clinical milieu, and prepare medical students for a lifetime of learning.
Medical EducationThe anxieties of new clinical students
132 Citations1992Fraser J. Moss, I. C. McManus
Doctors tended to overestimate anxiety concerning communication problems, and to underestimate anxiety concerning routine clinical tasks such as phlebotomy.
Academic MedicineA Snapshot of the Status of Problem-Based Learning in U. S. Medical Schools, 2003???04
115 Citations2005Scott Kinkade
Use of PBL is widespread in the preclinical curricula of U.S. medical schools, however, that use is limited, since fewer than 6% of programs use it for more than 50% of their instruction.
Medical EducationDevelopment of clinical reasoning from the basic sciences to the clerkships: a longitudinal assessment of medical students' needs and self‐perception after a transitional learning unit
107 Citations2003Élisabeth Van Gessel, Mathieu Nendaz +3 more
A 12‐week unit of Introduction to Clinical Reasoning (ICR) at the beginning of its fourth or clerkship year to facilitate students' transition from basic, science‐oriented, problem‐based learning (PBL) to clinical reasoning‐oriented PBL.
Perspectives in biology and medicineScience, Humanism, and the Nature of Medical Practice: A Phenomenological View
106 Citations1985Michael Schwartz, Osborne P. Wiggins
The explosive growth of medical knowledge entails an increasing specialization wherein no single physician remains competent to care for the overall needs of a patient.
Academic MedicinePromoting Fundamental Clinical Skills: A Competency-Based College Approach at the University of Washington
104 Citations2005Erika A. Goldstein, Carol F. MacLaren +6 more
An integrated developmental curriculum that emphasizes bedside teaching and role modeling, focuses on enhancing fundamental clinical skills and professionalism, and implements these goals via a new administrative structure, the College system, which consists of a core of clinical teachers who spend substantial time teaching and mentoring medical students.
Academic MedicineDo Clerkship Directors Think Medical Students Are Prepared for the Clerkship Years?
84 Citations2004Donna M. Windish, Paul Mark Paulman +2 more
Many medical schools may need to give more attention to the preclerkship preparation of students in these high-priority areas, as almost half of clerkship directors were concerned that students do not receive adequate preparation in key competencies before starting the core clinical clerkships.
Academic MedicineA Survey of Basic Technical Skills of Medical Students
58 Citations2004Charles W. Sanders, Janine C. Edwards +1 more
It is likely that half of the medical schools are not attaining the MSOP objective of rigorously teaching and evaluating technical procedures, as more measures and more sophisticated measures of physicians’ performance are being implemented in medical practice.
Academic MedicineIdentity Development in Professional Education* ???
55 Citations2005George B. Forsythe
What professionals know and can do is certainly critical—professional competence matters; however, these answers also suggest that who they are as professionals also counts.
PubMedA short transitional course can help medical students prepare for clinical learning.
50 Citations2005Heidi Chumley, Cynthia A. Olney +2 more
A transitional course based on common skills is relevant to students' clerkship experiences and can increase students' self-reported preparedness for the clinical years of medical school.
Academic MedicineEarly Introduction of Clinical Skills Improves Medical Student Comfort at the Start of Third-Year Clerkships
45 Citations2006Mark Whipple, Courtenay B. Barlow +2 more
A competency-based College system improves medical student comfort in core clinical skills at the start of the third year curriculum.
Medical EducationStudents’ perceptions of relationships between some educational variables in the out‐patient setting
44 Citations2002Diana Dolmans, H.A.P. Wolfhagen +3 more
The aim of this study is to investigate relationships among some educational variables in the out‐patient clinic.
Teaching and Learning in MedicineAn Encounter-Based Analysis of the Nature of Teaching and Learning in a 3rd-Year Medical School Clerkship
28 Citations2000Patricia A. Carney, Catherine Florio Pipas +5 more
This prospective study used both paper- and computer-based documentation systems to collect information on student-patient-preceptor encounters to explore how learning experiences vary by type of health care visit.
Academic MedicineThe evolution of courses in professional skills and perspectives for medical students
26 Citations1998Raymond H. Curry, Gregory Makoul
An overview article discusses the origins of interdisciplinary courses at Northwestern University, Oregon Health Sciences University, the University of California, Los Angeles, and theUniversity of Nebraska, and reviews the scope of the curricula now in place.
Medical TeacherStarting learning in medical practice: an evaluation of a new Introductory clerkship
25 Citations2005Johanna C. G. Jacobs, S. Bolhuis +3 more
The study demonstrates that it is possible to introduce innovations in clinical clerkships to improve the learning environment of work-based learning.
Learning and InstructionCognitive effects of practical experience in high- and low-achieving medical students
21 Citations1994Henny P. A. Boshuizen
It is concluded that high and low achievers do not differ in the way their knowledge structures change as a consequence of practical experience, and implications for teaching and learning in practical settings are discussed.
Academic MedicineGauging the Outcomes of Change in a New Medical Curriculum
13 Citations2000Gregory Makoul, Raymond H. Curry +1 more
The Student Perception Survey, which focuses on how students view both the learning environment and their own learning experiences, was first administered at Northwestern University Medical School in 1993 and has since been used by medical schools at the University of Chicago, Washington University, University of Utah, Medical University of South Carolina and, most recently, theUniversity of Minnesota at Duluth.