Reinforcement of occupational history taking: A success story

Background: This article describes the results of a retrospective study of 3 classes of medical students who participated in a targeted occupational a nd environmental health curriculum at the University of Connecticut School of Medicine. Purpose: We wanted to determine if targeted focused curricular intervention s which integrated occupational and environmental health principles into ro utine history taking would result in increased scores on the number of ques tions posed during the Clinical Skills Assessment Program in the 4th year. Methods: We analyzed Clinical Skills Assessment Program questions for 3 gra duating medical school classes from 1997 to 1999. Results: it appears that intense, focused training may increase the occupat ional and environmental questions which students ask. By revisiting the com ponents of the history during the 3rd year the final assessment of 4th-year students substantially and significantly increased. Conclusions: Those who wish to stem the decline in history-taking skills as students enter their clinical years should consider reinforcing these skil ls using structured programs and practice in areas of the history that are traditionally neglected bur recognized as essential in gathering comprehens ive data on patients. Copyright (C) 2001 by Lawrence Erlbaum Associates, In c.