The “Clerkship Passport” Increases Student Participation in the Third-Year Medical Student Obstetrics Clerkship

Abstract

PURPOSE: To develop and implement a clinical activity checklist to improve third-year medical student participation, satisfaction, and resident satisfaction on the Obstetrics Clerkship. BACKGROUND: The “Clerkship Passport” is a checklist of core clinical experiences that students should master. We hypothesized that its implementation would increase student participation and overall Obstetric Clerkship satisfaction. METHODS: The Passport was based on milestones 1 from the Ob/Gyn Milestones Project. Two student cohorts were studied before and after implementation (2/2017–3/2018). Overall participation was the primary outcome, secondary measures included task-specific participation and student and resident satisfaction. Chi-square, ANOVA, linear regression and qualitative coding were used for analysis. RESULTS: 79 of 84 (94%) third-year medical students participated. Overall participation rates increased from 68% to 87% on nine pre-determined tasks (p < 0.001). Participation rates were higher on the Passport (96%) than on anonymous survey (p < 0.001). Academic quarter and interest were associated with participation (p=0.011 and 0.002). After controlling for both, the passport still increased participation aOR 1.7 [1.1, 2.3]. Lactation counseling, knot tying and performing sterile speculum exams increased the most. Despite increased participation, satisfaction with “amount of hands-on experience” decreased (p = 0.03). The remainder of clerkship satisfaction scores were unchanged. Residents reported the Passport defined expectations, increased teaching, encouraged feedback and was not burdensome. DISCUSSION: This study supports the use of a clinical activity checklist, which improves student participation. Overall clerkship satisfaction is not improved, but students report satisfaction with the Passport itself. Residents also support the use of this checklist.