Michael Barone, MD; Robert Dudas, MD, Pediatrics Clerkship, Johns Hopkins University, Baltimore, MD
Background: The AAMC Task Force on the Clinical Skills Education of Medical Students recommends a longitudinal and developmental clinical skills program for all medical schools. Presently, few medical schools extend explicit clinical skills instruction into the clerkship years. Objective: During the process of our School of Medicine’s curriculum reform, clerkship directors agreed to dedicate a portion of their clinical “rotation” to structured clinical skills development. Within pediatrics, we sought to teach students core skills immediately before the start of the clerkship. More advanced skill training would occur at the mid-point of the 8-week rotation. The goal is to build student competency earlier in the clerkship in order to enhance student experience throughout the clerkship. Design/Methods: Curriculum development followed the 6 Step approach of Kern, et. al. Needs assessment included, 1) a review of previous student clerkship evaluations, 2) teaching faculty input and 3) a questionnaire given 10 days after the start of the clerkship. This posed a single question to students, “What specific skills do you wish you had been explicitly taught before you started seeing patients in this clerkship?” Students listed responses under subcategories of clinical skills; 1) Gathering data, 2) Interpreting data, 3) Conveying information, 4) Performing a physical examination and 5) Performing procedures. Results: Ten days into the pediatrics clerkship, students expressed a significant need for clinical skills instruction. In pediatrics, topics such as 1) taking an adolescent social history, 2) interpreting pediatric lab values / vital signs, and 3) performing the newborn examination, were among the most significant needs. We plan to address this through a series of workshops over 3-5 days utilizing small groups (5 students: 1 faculty) and active learning methods. Teaching modules have individual learning objectives and are formative. Curricular evaluation will occur through an end of third year OSCE as well as evaluations of fourth year medical students. Conclusions / Implications: This new curricular effort, known as PRECEDE (PRE-Clerkship EDucational Exercises), will take place in pediatrics and all other required clerkships in the School of Medicine, leaving open the opportunity for co-disciplinary teaching. It will begin in March 2010.