Positive Outcomes of Optimizing Student–Preceptor Continuity in a Traditional Block Clerkship

Biggs, Jennifer L; Sutherell, Jamie S; Remus, Rochelle; Armbrecht, Eric S.; King, Marta

doi:10.1080/10401334.2017.1412832

Cited by 6 publications

(3 citation statements)

References 29 publications

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“…Our results are consistent with prior studies that have demonstrated the positive influence of preceptor continuity in the outpatient setting 8,10,25 and hospital setting. 7,15,18,19 The studies by Bernard et al 7,15 focused on the emergency department setting, while Elnicki and Cooper 18 looked at preceptor and student reactions to increased continuity but did not investigate students' preceptor ratings.…”

Section: Discussionsupporting

confidence: 92%

“…Patient, peer, and preceptor continuity within the clinical learning environment has multiple benefits for medical students. [1][2][3][4][5][6] Preceptor continuity, in particular, has been associated with a number of positive outcomes, which include improved feedback to students, [7][8][9] students perceiving more accurate evaluations, 10 increased autonomy, 1,11 and increased trust from preceptors, 1,12 better overall ratings from students, 13,14 and more investment from preceptors. [15][16][17] Studies that have looked specifically at preceptor continuity in the inpatient setting have identified that increased inpatient continuity is associated with higher ratings from students 7 and faculty, 15 students perceiving higher quality feedback, 7 students performing more procedures, 11 and faculty reporting an improved ability to evaluate students.…”

Section: Introductionmentioning

confidence: 99%

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Association between inpatient team continuity and clerkship student academic performance

Sawicki,

Sriram,

Hansen

et al. 2024

Journal of Hospital Medicine

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ObjectiveTo determine the association between inpatient team continuity, defined as the maximum number of days the same student, resident, and attending worked together on the inpatient wards, and the academic performance of students in a pediatric block clerkship.MethodsWe retrospectively identified students who rotated in the pediatric clerkship at a single institution from 2020 to 2022. We used multiple linear regression models to adjust for multiple confounders and used a one‐way analysis of variance to compare adjusted outcomes across quartiles of inpatient team continuity.ResultsA total of 227 students were included in the analysis. Students' preceptor ratings increased by 0.04 on a scale of 0–4 (95% confidence interval [CI] 0.01–0.06; p = .001), and their final pediatric grade increased by 0.02 on a scale of 0–4 (95% CI 0.01–0.02; p < .001) with each 1‐day increase in inpatient team continuity. There was no statistically significant association between team continuity and shelf exam scores or observed structured clinical examination scores. Preceptor ratings and final clerkship grades increased across quartiles of team continuity, with the greatest increase being between the second, 6–7 days of continuity, and third, 8–10 days of continuity, quartiles.ConclusionsIncreased inpatient team continuity is associated with students receiving higher preceptor ratings and achieving a higher final pediatric clerkship grade. While the mechanisms driving these associations remain unknown, the results add to the literature base supporting the importance of preceptor continuity in undergraduate medical education.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Association between inpatient team continuity and clerkship student academic performance

Sawicki,

Sriram,

Hansen

et al. 2024

Journal of Hospital Medicine

View full text Add to dashboard Cite

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“…23 Our intervention provided students with an opportunity to experience the benefits of deliberate practice and continuity of feedback which has been shown to be valuable even in comparatively short placements of between 3 and 12 weeks. 24,25 Furthermore, some student comments suggest that their theoretical knowledge base led to a propensity to think in terms of "typical" presentations and to consider only a limited number of possibilities, often within a single organ system. The fact that they were based on specialized wards made broad thinking more problematic as they started to assume that certain symptoms (e.g., nausea) belonged to certain specialties (e.g., gastroenterology).…”

Section: Discussionmentioning

confidence: 99%

<p>Developing Medical Students’ Broad Clinical Diagnostic Reasoning Through GP-Facilitated Teaching in Hospital Placements</p>

Bansal¹,

Singh²,

Thompson³

et al. 2020

AMEP

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Purpose: Graduating medical students need broad clinical diagnostic reasoning skills that integrate learning across clinical specialties to deal with undifferentiated patient problems. The opportunity to acquire these skills may be limited during clinical placements on increasingly specialized hospital wards. We developed an intervention of regular general practitioner (GP) facilitated teaching in hospital placements to enable students to develop broad clinical diagnostic reasoning. The intervention was piloted, refined and delivered to a whole cohort of medical students at the start of their third year. This paper examines whether students perceived opportunities to improve their broad diagnostic clinical reasoning through our intervention. Methods: GP-facilitated teaching sessions were delivered weekly in hospital placements to small groups of 6-8 students for 90 mins over 6 weeks. Students practiced clinical reasoning with real patient cases that they encountered on their placements. Evaluation of learning outcomes was conducted through a student questionnaire using Likert scales with free-text boxes for additional explanation. Focus groups were conducted to gain a more in-depth understanding of student perspectives. Results: As high as 87% of students agreed that their broad clinical diagnostic reasoning ability had improved. Thematic analysis of the qualitative data revealed four factors supporting this improvement: practicing the hypothetico-deductive method, using real patient cases, composing student groups from different speciality placements and the breadth of the facilitators' knowledge. Students additionally reported enhanced person-centredness in terms of understanding the patient's perspective and journey. Students perceived that the added value of general practitioner facilitators lay in their broad knowledge base and knowledge of patient needs in the community. Conclusion: Our results suggest that medical students can develop broad clinical diagnostic reasoning skills in hospital settings through regular GP-facilitated teaching. Our approach has the advantage of working within the established curricular format of hospital placements and being deliverable at scale to whole student cohorts.

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Clinic Settings, Schedules, and Structures

Packer

2022

Excelling in the Clinic

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Positive Outcomes of Optimizing Student–Preceptor Continuity in a Traditional Block Clerkship

Cited by 6 publications

References 29 publications

Association between inpatient team continuity and clerkship student academic performance

Association between inpatient team continuity and clerkship student academic performance

<p>Developing Medical Students’ Broad Clinical Diagnostic Reasoning Through GP-Facilitated Teaching in Hospital Placements</p>

Clinic Settings, Schedules, and Structures

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