Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Aug;5(4):215-21.
doi: 10.1007/s40037-016-0287-z.

Pre-clerkship clinical skills and clinical reasoning course performance: Explaining the variance in clerkship performance : Pre-clerkship predictors of clerkship variance

Jeffrey S LaRochelle  1 , Ting Dong  2 , Steven J Durning  2
Affiliations

Pre-clerkship clinical skills and clinical reasoning course performance: Explaining the variance in clerkship performance : Pre-clerkship predictors of clerkship variance

Jeffrey S LaRochelle et al. Perspect Med Educ. 2016 Aug.

Abstract

Introduction: Evidence suggests that pre-clerkship courses in clinical skills and clinical reasoning positively impact student performance on the clerkship. Given the increasing emphasis on reducing diagnostic reasoning errors, it is very important to develop this critical area of medical education. An integrated approach between clinical skills and clinical reasoning courses may better predict struggling learners, and better allocate scarce resources to remediate these learners before the clerkship.

Methods: Pre-clerkship and clerkship outcome measures from 514 medical students graduating between 2009 and 2011were analyzed in a multiple linear regression model.

Results: Learners with poor performances on integrated pre-clerkship outcome measures had a relative risk of 6.96 and 5.85 for poor performance on National Board of Medical Examiners (NBME) subject exams and clerkship performance, respectively, and explained 22 % of the variance in clerkship NBME subject exam scores and 20.2 % of the variance in clerkship grades.

Discussion: Pre-clerkship outcome measures from clinical skills and clinical reasoning courses explained a significant amount of clerkship performance beyond baseline academic ability. These courses provide valuable information regarding student abilities, and may serve as an early indicator for students requiring remediation.

Conclusions: Integrating pre-clerkship outcome measures may be an important aspect of ensuring the validity of this information as the pre-clerkship curriculum becomes compressed, and may serve as the basis for identifying students in need of clinical skills remediation.

Keywords: Clinical reasoning; Clinical skills; Struggling learners.

PubMed Disclaimer

Similar articles

See all similar articles

Cited by

References

    1. Wenrich M, Jackson M, Scherpbier A, Wolfhagen I, Ramsey P, Goldstein E. Ready or not? Expectations of faculty and medical students for clinical skills preparation for clerkships. Med Educ Online. 2010 - PMC - PubMed
    1. Alexander E. Perspective: Moving students beyond an organ-based approach when teaching medical interviewing and physical examination skills. Acad Med. 2008;83:906–909. doi: 10.1097/ACM.0b013e318184f2e5. - DOI - PubMed
    1. Omori D, Wong R, Antonelli M, Hemmer P. Introduction to clinical medicine: a time for consensus and integration. Am. J. Med. 2005;118:189–194. doi: 10.1016/j.amjmed.2004.11.017. - DOI - PubMed
    1. Windish D, Paulman P, Goroll A, Bass E. Do Clerkship Directors Think Medical Students Are Prepared for the Clerkship Years? Acad Med. 2004;79:56–61. doi: 10.1097/00001888-200401000-00013. - DOI - PubMed
    1. Jackson M, Keen M, Wenrich M, Schaad D, Robins L, Goldstein E. Impact of a pre-clinical clinical skills curriculum on student performance in third-year clerkships. J Gen Intern Med. 2009;24:929–933. doi: 10.1007/s11606-009-1032-7. - DOI - PMC - PubMed

LinkOut - more resources