• Preceptor student 모두 LIC에서의 evaluation 가지 측면에서 낫다고 생각했다.
    • 과정의 타당성 : Validity of evaluation process
    • 평가의 질 : Quality of clinical skill evaluation
    • 건설적 피드백 : Willingness to provide constructive feedback.

  • 전통적인 방식의 clinical performance 평가가 가지는 가지 문제
    • 실제로 학생이 환자와 접하는 과정을 보지 못한 상태에서도, 며칠, 주의 Block clerkship 끝날 평가를 하게 .
    • 학생들의 임상 기술은 평가와 피드백을 통해서 향상되나, 평가는 rotation 말미에만 시행되기 때문에 건설적인 제안을 받지 못하고, 학생들의 실수는 그대로 유지된다.
    • 요약하자면, LIC 경우 학생들과 교수자 모두 평가가 공정하고, 정확하고, block보다 학생의 performance   반영한다고 받아들인다. 또한 faculty 학생 모두 faculty staff LIC상황에서 정직하고, 건설적인 피드백을 한다는 것에 동의했다






 2011 May;45(5):464-70. doi: 10.1111/j.1365-2923.2010.03904.x.

Perceptions of evaluation in longitudinal versus traditional clerkships.

Source

Department of Medicine, University of California San Francisco, San Francisco, California, USA. Lindsay.A.Mazotti@kp.org

Abstract

OBJECTIVES:

Methods for evaluating student performance in clerkships traditionally suffer shortcomings, partly as a result of clerkship structure. The purpose of this study was to compare preceptors' and students' perceptions of student evaluation in block clerkships and longitudinal integratedclerkships (LICs).

METHODS:

From 2007 to 2009, preceptors who taught on both block clerkships and an LIC were surveyed on their perceptions of clerkshipevaluation. Year 3 students were surveyed on their perceptions of clerkship evaluation at the year end. Responses from preceptors who completed both block clerkship and LIC surveys were compared using paired-samples t-test; student responses were compared using independent-samples t-test.

RESULTS:

Overall, 66% (67/102) of block clerkship and 75% (77/102) of LIC preceptors responded; 44% of preceptors (45/102) completed both block and LIC surveys. In total, 62% (68/110) of block clerkship and 83% (19/23) of LIC students responded. Both preceptors and students favouredevaluation in the LIC on three factors (p ≤ 0.01): validity of evaluation process, quality of clinical skill evaluation, and willingness to provide constructive feedback.

CONCLUSIONS:

Preceptors and students perceived evaluation in an LIC more favourably than evaluation on block clerkships. For educators working to improve student evaluation, further examination of the LIC structure and evaluation processes that seem to enhance both formative assessment and summative evaluation may be useful to improve the quality of evaluation and feedback.







  • 무조건 환자 수를 많이 보는 것만이 능사는 아니다.
    • Q. 오히려 적은 수라도 제대로 보는 것이 나을 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 exposure internal medicine clerkship performance 상관관계가 약하다.
    • (Clerkship process - Clerkship outcome 비교)







 2012 Jul;46(7):689-97. doi: 10.1111/j.1365-2923.2012.04283.x.

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.




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