Brief Summary of the Results from the 2006 Transitional Clerkship Evaluations

Julie Foertsch. IME Evaluator

In preparing for the 2007 Transitional Clerkship, we carefully considered the evaluation feedback that we received from three sources:
(a) the post-event evaluation questionnaires completed at the 2006 Transitional Clerkship by 140 of the 144 students who attended;
(b) a December 2006 online survey of 18 of 23 eligible Clerkship Directors asking them to rate that fall’s third-year medical students on their preparedness in twelve areas and note any changes they had noticed from previous classes,
(c) a January 2007 follow-up survey of 106 of the 144 third-year students to assess how well the Transitional Clerkship prepared them for the situations they faced in the first six months of clinical clerkships.

The evaluation reports for these surveys are available on request. There was a great deal of concordance in the data from all three sources, from which we were able to conclude the following:

After six months of clinical rotations, a total of 92% of students felt the Transitional Clerkship had a "significant impact" (22%) or "some impact" (70%) on their ability to assume the responsibilities expected of a third-year student.

The 2006 Transitional Clerkship was most successful in helping rising third-year students to:

• Understand what is expected in terms of professional behavior and attire
• Understand what is needed to maintain a sterile environment
• Do as asked of students in the hospital operating room
• Be sensitive to psychological, personal, and cultural factors during patient interactions

The Transitional Clerkship sessions that students valued most were those that:

• Provided ample opportunities for students to ask questions or practice skills themselves.
• Were led by someone with intimate knowledge of what it was like to be a 3rd-year medical student and knew from experience what issues or questions might arise.
• Were very concrete about the day-to-day knowledge students would need to perform tasks and meet expectations.
• Kept the amount of information to be absorbed manageable by focusing on the most important information or the things students would need to know when they first started.
• Didn’t repeat too much of what was said in earlier sessions.

The most frequent suggestions for improving the Transitional Clerkship for the next summer were:

• Allow more breaks for students to use the bathroom, get to their next session, and talk to presenters.
• Provide more time for hands-on skills practice so that everyone gets a chance to practice starting an IV and intubation; and provide some instruction on the IV lines, tubes, etc. that students are likely to encounter in the wards.
• Provide more instruction on paperwork, charts, writing orders, prescriptions and progress notes.
• In every session, spend less time on abstractions and theory and more on the practical “nuts & bolts” knowledge that students can use right away,
• Greatly reduce welcome speeches and the general introductory lectures that often begin the day or a set of sessions.
• Cut down the number of panels by removing redundant material and combining the mid-level practitioners, nurses, and residents into one panel.
• Create printed (and online) clerkship-specific reference materials students can take with them, most especially a handout from previous third-years with helpful hints on particular clerkships and guidelines on what to expect.
• Get more instruction and guidance from fourth-year students and residents who are closer to the students’ own level of experience and can warn students about things doctors, nurses, or more experienced team members might not think to tell them.