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. 2023 Mar 28;23(1):188.
doi: 10.1186/s12909-023-04167-7.

Needs assessment for enhancing pediatric clerkship readiness

Adam Weinstein  1 , Peter MacPherson  2 , Suzanne Schmidt  3 , Elizabeth Van Opstal  4 , Erica Chou  5 , Mark Pogemiller  6 , Kathleen Gibbs  7 , Melissa Held  8
Affiliations

Needs assessment for enhancing pediatric clerkship readiness

Adam Weinstein et al. BMC Med Educ. .

Abstract

Background: Many students report feeling inadequately prepared for their clinical experiences in pediatrics. There is striking variability on how pediatric clinical skills are taught in pre-clerkship curricula.

Methods: We asked students who completed their clerkships in pediatrics, family medicine, surgery, obstetrics-gynecology and internal medicine to rate their pre-clinical training in preparing them for each clerkship, specifically asking about medical knowledge, communication, and physical exam skills. Based on these results, we surveyed pediatric clerkship and clinical skills course directors at North American medical schools to describe the competence students should have in the pediatric physical exam prior to their pediatric clerkship.

Results: Close to 1/3 of students reported not feeling adequately prepared for their pediatrics, obstetrics-gynecology, or surgery clerkship. Students felt less prepared to perform pediatric physical exam skills compared to physical exam skills in all other clerkships. Pediatric clerkship directors and clinical skills course directors felt students should have knowledge of and some ability to perform a wide spectrum of physical exam skills on children. There were no differences between the two groups except that clinical skills educators identified a slightly higher expected competence for development assessment skills compared to pediatric clerkship directors.

Conclusions: As medical schools undergo cycles of curricular reform, it may be beneficial to integrate more pre-clerkship exposure to pediatric topics and skills. Further exploration and collaboration establishing how and when to incorporate this learning could serve as a starting point for curricular improvements, with evaluation of effects on student experience and performance. A challenge is identifying infants and children for physical exam skills practice.

Keywords: Clinical skills; Pediatric clerkship; Pediatric physical examination.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Comparison of student perceptions of feeling prepared between pediatrics and internal medicine (A), family medicine (B), obstetrics-gynecology (C), and surgery (D) clerkships. (ǂ p < 0.05 and * p < 0.005)
Fig. 2
Fig. 2
Level of competence medical students should have in performing pediatric specific physical exam skills on the day they start their pediatric clerkship. (Blue—Clinical Skills Directors; Orange—Pediatric Clerkship Directors)
Fig. 3
Fig. 3
Level of competence medical students should have in performing newborn specific physical exam skills and development assessment skills on the day they start their pediatric clerkship. 1 = No knowledge of exam maneuver or skill; 2 = Knowledge of their exam maneuver/skill without ability to perform; 3 = Knowledge of exam maneuver/skill with some ability to perform; 4 = Ability to perform maneuver or skill
Fig. 4
Fig. 4
When clinical skills directors and pediatric clerkship directors believe pediatric specific exam skills are taught for students in their school (A), and when they believe they should be taught for students in their school (B)
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