Demystifying "learning" in clinical rotations: do immersive patient encounters predict achievement on the clinical performance examination (CPX)?

Abstract

Background: Although the Liaison Committee on Medical Education required U.S. medical schools to quantify students' clinical encounters, optimum patient exposure needed to predict performance has been elusive. This study explored the relationship between comprehensive patient encounters logged on personal digital assistants (PDAs) during three medicine clerkships, to performance on a clinical performance examination (CPX).

Method: PDA log data for 166 medical students were used to identify educationally "rich" patient encounters, where students were assigned full responsibility for patient care.

Results: Univariate regression analyses predicting the effect of immersive patient encounters on CPX case scores did not show statistical significance.

Conclusions: Amount of patient exposure defined by the richness of student-patient interaction did not reflect on the CPX performance for six selected cases. Further research should examine qualitatively different learning experiences occurring with patient encounters and a higher volume of exposure to predict outcomes.