MONITORING STUDENTS CLINICAL-EXPERIENCES DURING A 3RD-YEAR FAMILY MEDICINE CLERKSHIP

Purpose. To demonstrate the importance of monitoring the clinical expe riences and types of supervision that students receive in physicians' offices, in order to ensure quality control during a required clerkshi p. Method. In a documentation system introduced in 1991-92, third-year students in the family medicine clerkship at the University of North Carolina at Chapel Hill School of Medicine were asked to complete an o ptical scan card for every patient they saw, The card information cons isted of demographic data, patient continuity, medical problems, types of histories and physical examinations, patient education issues, pri mary care procedures, and type of supervision. The data were collected from 293 students placed in 63 practices from December 1991 through N ovember 1993. Results. Hypertension, health maintenance, and upper res piratory infection were the most frequently recorded medical problems. Although the students obtained adequate experience performing focused histories and physicals, their experiences with certain physical exam inations (breast, rectal, and genital) were inconsistent. Patterns of supervision by the preceptors varied among practices. Conclusion. Alth ough the validity of the data has not been assessed, previous literatu re and other information indicate that the documentation system succes sfully described the students' clinical experiences. The benefits of i mplementing such a monitoring system include highlighting the students ' lack of certain experiences and making comparisons across sites in o rder to encourage change among preceptors.