Gary L. Beck, MA; Sharon R. Stoolman, MD, Pediatric Undergraduate Medical Education, University of Nebraska Medical Center, Omaha, NE
Background: During year three, students begin self-selecting the field of medicine which they intend to pursue. As a result, there are times when students will do the work required of them on the clerkship, but do not seem to invest in learning the material. This research has identified two different types of interest, individual and situational. Individual interest is an intrinsic quality, something that persists regardless of the situation. Situational interest emerges as learners find personal value in a particular educational context. Objective: The purpose of this study is to determine if specialty-specific case discussions lead to increased interest in learning pediatric medicine. Methods: During 2008/2009 academic year, students (n=121) participated in regularly scheduled clinical case discussions. At orientation, students completed a pre-course Interest In Pediatrics (IIP) questionnaire, using a Likert scale 1=Strongly Disagree to 5=Strongly Agree. For students completing the clerkship at UNMC, they were randomly assigned to a case discussion group. The situational interest group discussion emphasized how the case related to the medical specialty that interested students. The other group addressed the pathogenesis and treatment modalities pertinent to the case. Groups met twice during the 8-week clerkship. Students in greater Nebraska clinics completed cases and received feedback via email. The Interest in Pediatrics questionnaire was completed again at the end of the clerkship. Results: Wilcoxon signed-rank test was used to analyze results. For students in the situational interest group, interest increased from pre-IIP mean of 3.64 to post-IIP mean 4.22 (z=-2.994, p<.05, r=-.44). Each group indicated greater application of pediatric medicine on post questionnaire; the situation interest group demonstrated the greatest change from pre-IIP mean of 1.09 to post-IIP mean of 4.33 (z=-6.038, p<.05, r=-.88). Discussion: Students reported greater interest in pediatric medicine by the end of the clerkships. The greater level of interest in pediatrics from the situational interest case discussions indicates that making these sessions personally relevant to student career interest may enhance motivation. This in turn may enhance their learning during the clerkship. This educational approach needs to be extended to clinical settings to assess greater generalized results.