Melissa Held,University of Connecticut School of Medicine,Durham,CT,Adam R. Weinstein,Geisel school of medicine at Dartmouth,Lebanon,NH,Kathleen Gibbs,Icahn School of Medicine at Mount Sinai,New York,NY,Blair Hammond,Icahn School of Medicine at Mount Sinai,New York,NY,Linda O. Lewin,University of Maryland,Baltimore,Maryland
Medical schools teach a broad spectrum of basic science and clinical skills. There may be limited emphasis on pediatric disease and clinical practice; many students have little interaction with children. We found that one-third of medical students did not feel well-prepared for their pediatric clerkship. We aim to compare this perception to that for other clerkships.
Methods: We administered an anonymous survey to medical students at three schools completing their pediatrics, internal medicine, family medicine, and OB/GYN clerkships. Using a 1 to 5 scale, (1 poor, 5 excellent), students were asked to rate their perception of how well their first two years of medical school prepared them for that particular clerkship in the following areas: The clerkship (overall), communication skills, physical examination skills, medical knowledge, and vaccines/vaccine-preventable diseases.
Results: We gathered 302 responses from students completing a pediatrics, internal medicine, family medicine, or OB/GYN clerkship. Comparing medicine and pediatrics, students report a mean score of 3.71 for feeling prepared overall for their medicine clerkship versus 3.11 for pediatrics (p<0.0001). In communication skills, students report a mean of 3.85 for medicine and 3.31 for pediatrics (p<0.0002); for physical exam skills, 3.75 for medicine and 2.93 for pediatrics (p<0.0001); for medical knowledge, 3.74 versus 3.16 (p<0.0001). In vaccines/vaccine preventable diseases, students reported a mean of 3.0 in both medicine and pediatrics (p=NS).
Comparing family medicine with pediatrics revealed the following: For the overall clerkship preparedness, students reported a mean of 3.74 in family medince vs. 3.11 in pediatrics (p<0.004); for communication skills, 4.25 in family medicine vs. 3.31 in pediatrics (p<0.0002); for physical exam skills, 4.06 vs. 2.93 (p<0.0001); for medical knowledge, 3.58 vs. 3.16 (p<0.037); for vaccines, 2.74 vs. 3.0 (p=NS).
There were no significant differences between mean scores in preparedness for OB/GYN compared to pediatrics.
Conclusion: Students report feeling less prepared for their pediatrics clerkships compared to internal medicine and family medicine clerkships in all areas we assessed except for vaccines/vaccine preventable diseases. This data may help to provide curricular guidance as schools move towards integrating clinical experiences and topics earlier in medical school education.