Effect of a longitudinal course on student performance in clerkships

Objective: To determine the effect that a 3-year primary-care course experi ence with family medicine, internal medicine, or pediatric preceptors would have on clerkship performance in pediatrics and internal medicine, Design: In 1 academic year, third-year students were divided retrospectivel y into 3 groups based on preceptor type in the primary care course. An anal ysis of variance was conducted. When the analysis of variance showed statis tical significance, a multiple-comparison t test was performed. Setting: University medical school with a longitudinal preceptor experience . Participants: One hundred nine third-year medical students who participated in the primary care course and completed the pediatric and internal medici ne clerkships. Fifty-six students took part in the self-assessment portion of the study. Main Outcome Measures: Student performance scores in the pediatric clerkshi p and internal medicine clerk-ship were analyzed for significant difference s based on preceptor type. Student self-assessment on pediatric objectives was analyzed for significant differences based on preceptor experience. Results: Students with pediatric preceptors received higher clinical scores in the pediatric clerkship (P = .04) and perceived themselves as more adva nced on 18 of the 39 pediatric curriculum pretest self-assessment items. St udents with pediatric or internal medicine preceptors received significantl y higher scores on the written patient medical history and physical examina tions (P = .02). There were no significant differences on the pediatric wri tten examination. There were no significant performance differences in the internal medicine clerkship. All hypothesis testing was conducted at the 95 % confidence level. Conclusion: Experiences with pediatric preceptors in the early years of med ical school may improve a students performance and confidence in the pediat ric clerkship.