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      Ready or not? Expectations of faculty and medical students for clinical skills preparation for clerkships

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          Abstract

          Background

          Preclerkship clinical-skills training has received increasing attention as a foundational preparation for clerkships. Expectations among medical students and faculty regarding the clinical skills and level of skill mastery needed for starting clerkships are unknown. Medical students, faculty teaching in the preclinical setting, and clinical clerkship faculty may have differing expectations of students entering clerkships. If students’ expectations differ from faculty expectations, students may experience anxiety. Alternately, congruent expectations among students and faculty may facilitate integrated and seamless student transitions to clerkships.

          Aims

          To assess the congruence of expectations among preclerkship faculty, clerkship faculty, and medical students for the clinical skills and appropriate level of clinical-skills preparation needed to begin clerkships.

          Methods

          Investigators surveyed preclinical faculty, clerkship faculty, and medical students early in their basic clerkships at a North American medical school that focuses on preclerkship clinical-skills development. Survey questions assessed expectations for the appropriate level of preparation in basic and advanced clinical skills for students entering clerkships.

          Results

          Preclinical faculty and students had higher expectations than clerkship faculty for degree of preparation in most basic skills. Students had higher expectations than both faculty groups for advanced skills preparation.

          Conclusions

          Preclinical faculty, clerkship faculty, and medical students appear to have different expectations of clinical-skills training needed for clerkships. As American medical schools increasingly introduce clinical-skills training prior to clerkships, more attention to alignment, communication, and integration between preclinical and clerkship faculty will be important to establish common curricular agendas and increase integration of student learning. Clarification of skills expectations may also alleviate student anxiety about clerkships and enhance their learning.

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          Most cited references24

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          The integration ladder: a tool for curriculum planning and evaluation.

          R Harden (2000)
          Integration has been accepted as an important educational strategy in medical education. Discussions about integration, however, are often polarized with some teachers in favour and others against integrated teaching. This paper describes 11 points on a continuum between the two extremes. * Isolation * Awareness * Harmonization * Nesting * Temporal co-ordination * Sharing * Correlation * Complementary * Multi-disciplinary * Inter-disciplinary * Trans-disciplinary As one moves up the ladder, there is less emphasis on the role of disciplines, an increasing requirement for a central curriculum, organizational structure and a requirement for greater participation by staff in curriculum discussions and planning. The integration ladder is a useful tool for the medical teacher and can be used as an aid in planning, implementing and evaluating the medical curriculum.
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            Applying educational theory in practice.

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              AMEE Guide No. 21: Curriculum mapping: a tool for transparent and authentic teaching and learning.

              R Harden (2001)
              The curriculum is a sophisticated blend of educational strategies, course content, learning outcomes, educational experiences, assessment, the educational environment and the individual students' learning style, personal timetable and programme of work. Curriculum mapping can help both staff and students by displaying these key elements of the curriculum, and the relationships between them. Students can identify what, when, where and how they can learn. Staff can be clear about their role in the big picture. The scope and sequence of student learning is made explicit, links with assessment are clarified and curriculum planning becomes more effective and efficient. In this way the curriculum is more transparent to all the stakeholders including the teachers, the students, the curriculum developer, the manager, the public and the researcher. The windows through which the curriculum map can be explored may include: (1) the expected learning outcomes; (2) curriculum content or areas of expertise covered; (3) student assessment; (4) learning opportunities; (5) learning location; (6) learning resources; (7) timetable; (8) staff; (9) curriculum management; (10) students. Nine steps are described in the development of a curriculum map and practical suggestions are made as to how curriculum maps can be introduced in practice to the benefit of all concerned. The key to a really effective integrated curriculum is to get teachers to exchange information about what is being taught and to coordinate this so that it reflects the overall goals of the school. This can be achieved through curriculum mapping, which has become an essential tool for the implementation and development of a curriculum. Faced with curricula which are becoming more centralized and less departmentally based, and with curricula including both core and optional elements, the teacher may find that the curriculum map is the glue which holds the curriculum together.
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                Author and article information

                Journal
                Med Educ Online
                MEO
                Medical Education Online
                Medical Education Online
                1087-2981
                06 August 2010
                2010
                : 15
                : 10.3402/meo.v15i0.5295
                Affiliations
                [1 ]Office of the Dean, University of Washington School of Medicine, Seattle, WA, USA
                [2 ]Department of Medicine, Division of General Internal Medicine, University of Washington School of Medicine, Seattle, WA, USA
                [3 ]Institute for Medical Education, Faculty of Health, Medicine, and Life Sciences, Maastricht University, Maastricht, the Netherlands
                [4 ]Department of Educational Evaluation and Research, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
                [5 ]School of Medicine, University of Washington, Seattle, WA, USA
                Author notes
                [* ] Marjorie Wenrich, Office of the Dean, University of Washington School of Medicine, Seattle, WA, USA. Email: maxter@ 123456u.washington.edu
                Article
                MEO-15-5295
                10.3402/meo.v15i0.5295
                2919534
                20711483
                583215d8-027d-4c7c-bc50-a2ad4ff74239
                ©2010 Marjorie Wenrich et al.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution-Noncommercial 3.0 Unported License, permitting all non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 13 May 2010
                : 07 July 2010
                : 13 July 2010
                Categories
                Research Article

                Education
                clerkships,curriculum,clinical skills,preclinical medical education,bedside teaching
                Education
                clerkships, curriculum, clinical skills, preclinical medical education, bedside teaching

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