ORAL PRESENTATION

The Effect of Two Different Models of Undergraduate Clinical Clerkships on Students' Educational Outcomes, Attitudes, and Career Choices.

Objectives: The Glasgow Service, an innovate structure in the third-year pediatric clerkship at the University of Utah School of Medicine, is composed of an attending, a senior resident, and four medical students, but no interns. The authors conducted a randomized controlled trial to test the hypotheses that this service produces improved educational processes, improved educational outcomes, increased student satisfaction, and greater interest in pediatrics.

Methods: During the 2001-3 academic years, 203 students were randomly assigned to the innovative (n = 128) and traditional services (n = 75). Multiple outcome parameters were evaluated including patient logs, evaluations, examination scores, a survey, and career choices.

Results: While the students on the conventional teams saw more patients (11.3 vs 9.9, p = 0.0009), the students on the innovative service cared for more key diagnoses (4.4 vs 3.6, p = 0.0009). Although the mean National Board of Medical Examiners subject examination scores were not statistically different (73 vs 72, p = 0.3910), residents and faculty evaluated the students on the Glasgow Service more favorably in three of eighteen categories. Additionally, the students on the Glasgow Service rated their overall experience and degree of participation in patient care more highly. The percentage of students on the Glasgow Service who matched in pediatrics was twice as large (Odds Ratio 2.52, 95% Confidence Interval 0.99-6.37).

Conclusions: An innovative structure for the third-year pediatric clerkship, which focuses on medical students, maintains or improves educational outcomes, increases student satisfaction, and raises student interest in pediatrics.