Rationale and Objectives
The authors performed this study to develop, implement, and evaluate a dedicated core clerkship in radiology for the required clinical clerkship year of medical school, and to compare it with the distributed core clerkship that it replaced.
Materials and Methods
A dedicated 5-day clerkship was added to the clinical core year of medical school. The course offered a variety of learning experiences, including lectures, clinical observation, case discussions, and a team project. Learner achievement was measured by posttest and compared with a control group. Student satisfaction was determined by structured and unstructured surveys. Faculty comment was elicited by survey, and administrative staff perspective was established through interviews. The evaluation of the dedicated clerkship was compared with the distributed clerkship along the dimensions of learner achievement, student satisfaction, faculty comment, and administrative staff perspective.
Results
The dedicated clerkship was developed and implemented successfully. Compared with the distributed clerkship, there was no significant difference in learner achievement or student satisfaction for the dedicated clerkship, but the dedicated clerkship was easier to conduct for faculty and administrative staff.
Conclusion
The dedicated clerkship was advantageous for faculty and administrative staff, whereas maintaining a comparable level of learner achievement and student satisfaction as the distributed clerkship.
In 1998, our medical school implemented a new undergraduate curriculum that stressed problem-based learning and computer delivery of instructional materials. To this end, all medical students were provided with laptop computers and technical support, and the local area network was expanded to cover the entire medical center. This created the opportunity to augment instruction in diagnostic radiology during various portions of the curriculum by incorporating computer aided instruction (CAI) radiology modules, however radiology was not originally included among the core clinical rotations. After a process of negotiation with the curriculum committee and the core clerkship directors, a required radiology clerkship was accepted into the core clinical year as a series of 10 independent half-day teaching sessions distributed throughout the year, and partially integrated with existing clerkships.
Web-based curriculum materials, in-class lectures, and tutorials were developed for the radiology clerkship. Subsequently, it was demonstrated that a Web-supported radiology curriculum distributed over a required clinical clerkship year was feasible, but several disadvantages were observed ( ). The disadvantages included discontinuity in episodes of teaching, conflicts with patient care responsibilities in other rotations that prevented students from attending all lectures and tests, and complex administration and scheduling. It had been hoped that the clinical rotations into which the radiology sessions were integrated would complement one another. Unavoidably, nevertheless, schedules were often in conflict and at times the radiologic topics did not correlate well with the clinical clerkships. The success of the distributed core clerkship, in spite of its disadvantages, ultimately led the medical school to consolidate it as a 5-day dedicated clerkship within the required clinical core year.
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Materials and methods
Development and Implementation
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Table 1
Sample Student Schedule for Dedicated Radiology Clerkship
Time Day 1 Day 2 Day 3 Day 4 Day 5 7:30–8:15 Resident lecture Resident lecture Resident lecture Resident lecture Resident lecture 8:30–9:00 Morning activity Orientation Quiz 1: bone Quiz 2: chest Quiz 3: pediatrics Team project 9:00–10:30 Lecture block
10:30–12:00 Observation block Clinical area Clinical area Clinical area Clinical area Clinical area 12:00–1:30 Midday block Resident conference 12:30–1:15 Resident conference 12:30–1:15 Resident conference 12:30–1:15 Resident conference 12:30–1:15 Resident conference 12:30–1:15 1:30–3:00 Tutorial block Arthritis tutorial Chest radiology tutorial Osteoporosis tutorial Imaging for screening Final exam 3:15–4:45 Case discussion block Case discussion: fractures Case discussion: chest Case discussion: pediatrics Case discussion: neuroradiology Final exam
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Table 2
Clinical Observation Areas, Activities, and Educational Objectives
Area and Capacity Activities and Educational Objectives
CT: computed tomography.
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Evaluation
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Attendance
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Learner Achievement
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Student Satisfaction
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Faculty Survey
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Comparison with Distributed Clerkship
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Results
Evaluation
Attendance
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Learner achievement
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Student satisfaction
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Table 3
Results of Structured Evaluation of the Dedicated Clerkship
Best Worst_n_ ⁎ Mean 1 2 3 4 5 Quiz and answer sessions Overall educational value 61 36 6 1 0 104 1.49 Fairness 69 30 4 1 0 104 1.39 Lectures and tutorials Overall educational value 47 50 6 0 0 103 1.60 Quality of presentations 39 49 13 2 0 103 1.79 Clinical areas Overall educational value 18 35 37 13 1 104 2.46 Content appropriateness 21 37 38 8 0 104 2.32 Case discussion Overall educational value 45 43 13 4 0 105 1.77 Quality of presentations 39 42 19 3 1 104 1.89 Team case presentation Overall educational value 41 44 14 4 0 103 1.82 Quality of presentations 39 46 15 3 0 103 1.83 Course Web site Ease of use 65 33 6 0 0 104 1.43 Content appropriateness 73 25 6 0 0 104 1.36 Required Textbook Readability 65 24 13 2 0 104 1.54 Content appropriateness 56 26 19 3 0 104 1.70 Evaluation of entire course Overall educational value 49 46 6 0 0 101 1.57 Organization 58 40 4 0 0 102 1.47
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Faculty survey
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Table 4
Results of Faculty Survey
Agree Strongly Agree Neutral Disagree Disagree Strongly I had no trouble meeting my teaching commitments 3 7 1 The content was appropriate 5 6 The course was well organized 6 5 The students appeared interested and enthusiastic 3 5 2 1 The support staff were helpful 7 4 I received student evaluations of my teaching 8 2 1 I found it enjoyable to teach in the course 6 4 1 I liked the format of the course 5 5 1 I used the Website to archive my teaching materials for the course 2 2 5 2 I checked the Website for my teaching schedule 1 3 5 2 The staff reminded me of my teaching commitments 7 4
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Comparison with Distributed Clerkship
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Attendance
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Learner achievement
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Student satisfaction
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Faculty survey
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Interview with administrative staff
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Discussion
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Acknowledgments
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