THE EFFECT OF A REQUIRED 3RD-YEAR FAMILY MEDICINE CLERKSHIP ON MEDICAL-STUDENTS ATTITUDES - VALUE INDOCTRINATION AND VALUE CLARIFICATION

Background. The effect of a required six-week third-year family medici ne clerkship was examined within a framework of professional socializa tion. Socialization was considered to consist of an institutional proc ess, i.e., value indoctrination, and a learner process, i.e., value cl arification. Method. Pre- and postclerkship data from 1,095 students ( classes of 1981-1993) at the University of Arizona College of Medicine were analyzed. In addition, specialty match data were obtained. Facto r analysis of 19 items on the pre- and postclerkship questionnaires wa s used to derive four scales measuring attitudes related to family med icine. The students were first grouped into four groups: those who pre ferred family medicine before and after the clerkship, those who prefe rred other specialties both times, those who switched to family medici ne, and those who switched away from family medicine. Then the student s were grouped into eight groups by dividing each of the specialty-pre ference groups into two sections: those who matched to family medicine and those who did not. Statistical comparisons involved the use of th e t and F statistics. Results. Usable data were available for a maximu m of 997 students (91%). The students' attitudes about family medicine changed during the clerkship to become more consistent with their pos tclerkship specialty preferences. In addition, more students preferred family medicine after the clerkship than before it. When each group w as further divided into those matching and not matching into family me dicine, no significant difference in attitudes was found between those matching and those not matching. Conclusion. These results reflect bo th a value clarification process and a value indoctrination effect. Th e discrepancy between postclerkship specialty preferences and later ma tch data indicates that the indoctrination effect and clarification pr ocess continue into the fourth year.