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Effect of a longitudinal course on student performance in clerkships.

OBJECTIVE
To determine the effect that a 3-year primary-care course experience with family medicine, internal medicine, or pediatric preceptors would have on clerkship performance in pediatrics and internal medicine.


DESIGN
In 1 academic year, third-year students were divided retrospectively into 3 groups based on preceptor type in the primary care course. An analysis of variance was conducted. When the analysis of variance showed statistical significance, a multiple-comparison t test was performed.


SETTING
University medical school with a longitudinal preceptor experience.


PARTICIPANTS
One hundred nine third-year medical students who participated in the primary care course and completed the pediatric and internal medicine clerkships. Fifty-six students took part in the self-assessment portion of the study.


MAIN OUTCOME MEASURES
Student performance scores in the pediatric clerkship and internal medicine clerkship were analyzed for significant differences based on preceptor type. Student self-assessment on pediatric objectives was analyzed for significant differences based on preceptor experience.


RESULTS
Students with pediatric preceptors received higher clinical scores in the pediatric clerkship (P = .04) and perceived themselves as more advanced on 18 of the 39 pediatric curriculum pretest self-assessment items. Students with pediatric or internal medicine preceptors received significantly higher scores on the written patient medical history and physical examinations (P = .02). There were no significant differences on the pediatric written examination. There were no significant performance differences in the internal medicine clerkship. All hypothesis testing was conducted at the 95% confidence level.


CONCLUSION
Experiences with pediatric preceptors in the early years of medical school may improve a student's performance and confidence in the pediatric clerkship.