임상 실습을 열심히 한 학생이 과연 시험도 잘 볼까?
- 무조건 환자 수를 많이 보는 것만이 능사는 아니다.
- Q. 오히려 적은 수라도 제대로 보는 것이 더 나을 수 있을까?
- 기존의 다른 연구들도 비슷한 결과를 내놓은 것이 많다.
- 1쿼터에서 4쿼터로 갈수록 보는 환자 수가 감소한다
- (Post hoc Bonferroni multiple comparisons indicated that, on average, students in clerkships in quarter 1 reported significantly more patients than those in clerkships in quarters 3 (p < 0.01) and 4 (p < 0.01). )
- Clinical exposure가 internal medicine clerkship performance와 상관관계가 약하다.
- (Clerkship process - Clerkship outcome의 비교)
Relationship between clinical experiences and internal medicine clerkship performance.
Source
Department of Preventive Medicine and Biometrics, Uniformed Services University of the Health Sciences (USUHS), Bethesda, MD 20814, USA. ting.dong@usuhs.mi
Abstract
OBJECTIVES:
This study was conducted to assess the associations between several clerkship process measures and students' clinical and examination performance in an internal medicine clerkship.
METHODS:
We collected data from the internal medicine clerkship at one institution over a 3-year period (classes of 2010-2012; n = 507) and conducted correlation and multiple regression analyses. We examined the associations between clerkship process measures (student-reported number of patients evaluated, percentage of core problems encountered, total number of core problems encountered, total number of clinics attended) and four clerkship outcomes (clinical points [a weighted summation of a student's clinical grade recommendations], ambulatory clinical points [the out-patient portion of clinical points], examination points [a weighted summation of scores on three clerkship examinations], and National Board of Medical Examiners examination score).
RESULTS:
After controlling for pre-clerkship ability and gender, percentage of core problems was significantly associated with ambulatory clinicalpoints (b = 3.84, total model R(2) = 0.14). Further, number of patients evaluated was significantly associated with clinical points (b = 0.19, total model R(2) = 0.22), but only for students who undertook first-quarter clerkships, who reported higher numbers of patients.
CONCLUSIONS:
Notwithstanding a few positive (but small) associations, the results from this study suggest that clinical exposure is, at best, weakly associated with internal medicine clerkship performance.