TY - JOUR
T1 - An Encounter-Based Analysis of the Nature of Teaching and Learning in a 3rd-Year Medical School Clerkship
AU - Carney, Patricia A.
AU - Pipas, Catherine F.
AU - Eliassen, M. Scottie
AU - Donahue, Dennis A.
AU - Kollisch, Donald O.
AU - Gephart, Dale
AU - Dietrich, Allen J.
N1 - Funding Information:
This project was supported by a U.S. Public Health Service Predoctoral Training in Family Medicine Grant (5D15 PE80040). Correspondence may be sent to Patricia A. Carney, PhD, Dartmouth Medical School, Medical Center Dr. HB 7925, Lebanon, NH E-mail: Patricia.A.Carney@dartmouth.edu
PY - 2000
Y1 - 2000
N2 - Background: Much of medical education has shifted from the hospital to ambulatory settings where each student works with a preceptor. Purpose: Our objectives were to describe the nature of community-based learning and to explore how learning experiences vary by type of health care visit. Methods: This prospective study used both paper-and computer-based documentation systems to collect information on student-patient-preceptor encounters. A consecutive sample of 3rd-year medical students contributed data on 1 full clinical day each week as they rotated through a required 8-week family medicine clerkship. The main measures of interest included patient age, gender, health care visit type (acute, acute exacerbation of chronic, chronic, and health maintenance), method of learning in history taking and physical examinations (observing preceptor, being observed by preceptor, performing unobserved, or working jointly with preceptor), content of physical examinations, amount of preceptor feedback, and preceptor teaching content. Results: Sixty-three students contributed data on 4,083 patient encounters. The majority of visits concerned acute complaints (37.7%) or health maintenance (26.4%). Many encounters involved students conducting the cardiovascular and pulmonary exams (33.2% each); fewer encounters involved neurologic (6.9%), gynecological (4.5%), and genitourinary (2.2%) exams. Students reported being observed performing histories and physical exams in 4% and 6% of encounters respectively. The most common student experiences were performing histories and performing physical exams unobserved during acute visits, which accounted for 65.8% and 52.4% of encounters overall. Conclusions: This system is useful for determining educational content and processes that occur in ambulatory settings. Important differences were found in teaching and learning by type of health care visit. This factor can and should be used when considering how students meet educational objectives in community-based ambulatory settings.
AB - Background: Much of medical education has shifted from the hospital to ambulatory settings where each student works with a preceptor. Purpose: Our objectives were to describe the nature of community-based learning and to explore how learning experiences vary by type of health care visit. Methods: This prospective study used both paper-and computer-based documentation systems to collect information on student-patient-preceptor encounters. A consecutive sample of 3rd-year medical students contributed data on 1 full clinical day each week as they rotated through a required 8-week family medicine clerkship. The main measures of interest included patient age, gender, health care visit type (acute, acute exacerbation of chronic, chronic, and health maintenance), method of learning in history taking and physical examinations (observing preceptor, being observed by preceptor, performing unobserved, or working jointly with preceptor), content of physical examinations, amount of preceptor feedback, and preceptor teaching content. Results: Sixty-three students contributed data on 4,083 patient encounters. The majority of visits concerned acute complaints (37.7%) or health maintenance (26.4%). Many encounters involved students conducting the cardiovascular and pulmonary exams (33.2% each); fewer encounters involved neurologic (6.9%), gynecological (4.5%), and genitourinary (2.2%) exams. Students reported being observed performing histories and physical exams in 4% and 6% of encounters respectively. The most common student experiences were performing histories and performing physical exams unobserved during acute visits, which accounted for 65.8% and 52.4% of encounters overall. Conclusions: This system is useful for determining educational content and processes that occur in ambulatory settings. Important differences were found in teaching and learning by type of health care visit. This factor can and should be used when considering how students meet educational objectives in community-based ambulatory settings.
UR - http://www.scopus.com/inward/record.url?scp=0034573177&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0034573177&partnerID=8YFLogxK
U2 - 10.1207/S15328015TLM1201_4
DO - 10.1207/S15328015TLM1201_4
M3 - Article
C2 - 11228863
AN - SCOPUS:0034573177
SN - 1040-1334
VL - 12
SP - 21
EP - 27
JO - Teaching and Learning in Medicine
JF - Teaching and Learning in Medicine
IS - 1
ER -