PURPOSE: To know the current status and to improve the internal medicine clinical clerkship in one medical school, the author performed a mid-term survey of the students.
METHODS: Questions were given to 48 students at the midpoint of their internal medicine clinical clerkship. Questions were about understanding the of purpose of the rotation, ability to do physical examination and procedures, bedside teaching experience and conferences, and support during clinical clerkship. Questions used 5-point Likert scale. 48 of 48 students responded. Average points for each question were calculated, and similar free answers were categorized together. RESULTS: Students began their clinical clerkship with high expectations, but soon fell into a 'busy but know-nothing' state. The purpose of the clinical clerkship was not clearly outlined. Students learned physical examination skills and procedures not directly from instructors but by watching over-the-shoulder. Bedside teaching was, in fact, 'table side' teaching. Instructors did not provide immediate feedback at the bedside on how the student gathered information from patients, Students attended conferences targeted towards residents, and they could not understand the ensuing discussions. Students had no sense of belonging to the ward team. This result was reported during a medical grand round with simple short-term strategies, which could be performed easily, and with longer-term strategies requiring more resources. CONCLUSION: The author did a mid-term survey of a clinical clerkship and reported the result with suggested strategies for improvement. The result was distributed to the faculty at other departments as well. Although there was resistance to the suggestions from the internal medicine department, this report was used to initiate clinical clerkship improvement to the clerkship in other departments. The author discusses this result along with a literature review. This paper can be a good resource for medical schools wanting to evaluate and improve their clinical clerkship.
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