COMSEP 2009 Baltimore Meeting with APPD
UTILIZING A CLERKSHIP WIDE ORIENTATION PROGRAM FOR A MULTI-SITE CLERKSHIP TO IMPROVE STUDENT PERCEPTION OF CLERKSHIP PREPAREDNESS AND STUDENT PERFORMANCE ON OSCE TESTING
Lee T. Miller, MD, Kathy L. Perkins, MD, PhD, Deborah Lehman, MD, LuAnn Wilkerson, EdD, Angelika Rampal, MD, David Geffen School of Medicine at UCLA, Los Angeles, CA
BACKGROUND: In the middle of the 2007-08 academic year a new orientation program was introduced to our core pediatric clerkship to insure that students in a multi-site clerkship received a comprehensive and consistent introduction to fundamental principles that would serve as a foundation for their subsequent clerkship experience. The Orientation Program highlighted aspects of the history and physical examination that are unique to pediatric medicine, with an emphasis on the organization and structure of the pediatric history. By introducing this Orientation Program in the middle of the academic year, we were able to compare student performance on a senior OSCE between groups receiving the orientation and groups that didn’t. Specifically, we focused on the following outcomes: history taking skills and physician/patient interaction skills in a pediatric OSCE case. We were also able to compare the students in the two groups on their self-reported preparation for the clerkship. METHODS: The responses of third-year students in evaluating the pediatric clerkship and their scores on the pediatric components of a year-end OSCE were compared using multiple analysis of variance controlling for the total OSCE score. RESULTS: 1. Students rated their preparation for the clerkship higher if they had participated in the orientation than if they had not. 2. Students who had participated in the Orientation Program scored significantly higher on history taking in the pediatric case during the OSCE (p<.05) than those who did not participate in the program. There was no effect on the physician/patient interaction score. CONCLUSION: In addition to the above, while the OSCE demonstrated improvement in history taking, analysis of oral presentations made after the pediatric patient encounter revealed that many students had significant difficulties organizing and synthesizing clinical information. These data will be shared, along with implications for program evaluation, curricular change and subsequent study.