Academic Medicine. 79(3):276-280, MARCH 2004
PMID: 14985204
Issn Print: 1040-2446
Publication Date: March 2004
Direct Observation of Students during Clerkship Rotations: A Multiyear Descriptive Study
Lisa Howley;William Wilson;
+ Author Information
Dr. Howleyis assistant professor of research in education, College of Education, University of North Carolina at Charlotte, Charlotte, North Carolina. At the time this research was conducted, Dr. Howley was assistant professor of research in medical education at the University of Virginia School of Medicine, Charlottesville, Virginia.Dr. Wilsonis professor of pediatrics at the University of Virginia School of Medicine.
Abstract
To determine how often students report that they are observed while performing physical examinations and taking histories during clerkship rotations.From 1999–2001, 397 students at the University of Virginia School of Medicine were asked at the end of their third year to report the number of times they had been observed by a resident or faculty member while taking histories and performing physical examinations on six rotations.Three hundred and forty-five students (87%) returned the survey instrument; of these, 322 (81%) returned instruments with complete information. On average, the majority reported that they had never been observed by a faculty member while taking a history (51%), performing a focused physical examination (54%), or a complete physical examination (81%). The majority (60%) reported that they had never been observed by a resident while performing a complete physical examination. Faculty observations occurred most frequently during the four-week family medicine rotation and least frequently during the 12-week surgery rotation. The length of the clerkship rotation was inversely related to the number of reported observations, χ2 (5, n = 295) = 127.85, p < .000.Although alternative assessments of clinical skills are becoming more common in medical education, faculty ratings based on direct observation are still prominent. The data in this study reflect that these observations may actually be occurring quite infrequently, if at all. Decreasing the evaluative weight of faculty and resident ratings during the clerkship rotation may be necessary. Otherwise, efforts should be made to increase the validity of these ratings.
