Purpose This study examined the short-term effects of a 2-week clinical clerkship program in rural and underserved public hospitals on medical students’ perceptions of public healthcare and their intentions to work in non-metropolitan public hospital settings.
Methods The Public Hospital Clinical Clerkship Program (PHCCP) was implemented for fifth- and sixth-year medical students from five medical schools in South Korea during 2023 and 2024. The program included clinical observation, mentoring by public hospital physicians, and exposure to community-based healthcare services. Students completed self-administered questionnaires before and after the program assessing perceptions of public hospitals and intentions to work in rural or underserved areas. Post-program satisfaction with program structure and components was also evaluated. Pre–post changes were analyzed using paired t-tests.
Results Paired pre- and post-program analyses included 24 students from the 2023 cohort and 36 students from the 2024 cohort. Students showed significantly increased intentions to work in public hospitals and rural or small-city settings after the program in both cohorts (all p<0.05). Positive changes were also observed in perceptions of public healthcare roles and support for public hospital careers. Overall satisfaction with the program was above average, particularly for mentoring, program structure, and educational value.
Conclusion A structured, short-term clinical clerkship in rural and underserved public hospitals can positively influence medical students’ perceptions of public healthcare and their intentions to work in non-metropolitan settings. Programs such as the PHCCP may represent a feasible educational strategy to enhance exposure to public and regional healthcare within existing medical curricula.
Purpose The aim of this study was to inquire about the clinical performance and determine the performance pattern of medical students in standardized patient (SP) based examinations of domestic violence (DV).
Methods The clinical performance sores in DV station with SP of third-year (n=111, in 2014) and 4th-year (n=143, in 2016) medical students of five universities in the Busan-Gyeongnam Clinical Skills Examination Consortium were subjected in this study. The scenarios and checklists of DV cases were developed by the case development committee of the consortium. The students’ performance was compared with other stations encountered in SP. The items of the checklists were categorized to determine the performance pattern of students investigating DV into six domains: disclosure strategy (D), DV related history taking (H), checking the perpetrator’s psychosocial state (P), checking the victim’s condition (V), negotiating and persuading the interviewee (N), and providing information about DV (I).
Results Medical students showed poorer performance in DV stations than in the other stations with SP in the same examination. Most students did confirm the perpetrator and commented on confidentiality but ignored the perpetrator’s state and patient’s physical and psychological condition. The students performed well in the domains of D, H, and I but performed poorly in domains P, V, and N.
Conclusion Medical students showed poor clinical performance in the DV station. They performed an ‘event oriented interview’ rather than ‘patient centered’ communication. An integrated educational program of DV should be set to improve students’ clinical performance.
Citations
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Methods Third-year medical school students (n=313) in Busan-Gyeongnam consortium in 2014 were included in the study. One of 12 stations was developed to assess clinical reasoning abilities. The scenario and checklists of the station were revised by six experts. Chief complaint of the case was rhinorrhea, accompanied by fever, headache, and vomiting. Checklists focused on identifying of the main problem and systematic approach to the problem. Students interviewed the patient and recorded subjective and objective findings, assessments, plans (SOAP) note for 15 minutes. Two professors assessed students simultaneously. We performed statistical analysis on their scores and survey.
Results The Cronbach α of subject station was 0.878 and Cohen κ coefficient between graders was 0.785. Students agreed on CPX as an adequate tool to evaluate students’ performance, but some graders argued that the CPX failed to secure its validity due to their lack of understanding the case. One hundred eight students (34.5%) identified essential problem early and only 58 (18.5%) performed systematic history taking and physical examination. One hundred seventy-three of them (55.3%) communicated correct diagnosis with the patient. Most of them had trouble in writing SOAP notes.
Conclusion To gain reliability and validity, interrater agreement should be secured. Students' clinical reasoning skills were not enough. Students need to be trained on problem identification, reasoning skills and accurate record-keeping.
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