Clinical Clerkship Research Articles

ChatGPT-4 Omni Performance in USMLE Disciplines and Clinical Skills: Comparative Analysis.

Recent studies, including those by the National Board of Medical Examiners, have highlighted the remarkable capabilities of recent large language models (LLMs) such as ChatGPT in passing the United States Medical Licensing Examination (USMLE). However, there is a gap in detailed analysis of LLM performance in specific medical content areas, thus limiting an assessment of their potential utility in medical education. This study aimed to assess and compare the accuracy of successive ChatGPT versions (GPT-3.5, GPT-4, and GPT-4 Omni) in USMLE disciplines, clinical clerkships, and the clinical skills of diagnostics and management. This study used 750 clinical vignette-based multiple-choice questions to characterize the performance of successive ChatGPT versions (ChatGPT 3.5 [GPT-3.5], ChatGPT 4 [GPT-4], and ChatGPT 4 Omni [GPT-4o]) across USMLE disciplines, clinical clerkships, and in clinical skills (diagnostics and management). Accuracy was assessed using a standardized protocol, with statistical analyses conducted to compare the models' performances. GPT-4o achieved the highest accuracy across 750 multiple-choice questions at 90.4%, outperforming GPT-4 and GPT-3.5, which scored 81.1% and 60.0%, respectively. GPT-4o's highest performances were in social sciences (95.5%), behavioral and neuroscience (94.2%), and pharmacology (93.2%). In clinical skills, GPT-4o's diagnostic accuracy was 92.7% and management accuracy was 88.8%, significantly higher than its predecessors. Notably, both GPT-4o and GPT-4 significantly outperformed the medical student average accuracy of 59.3% (95% CI 58.3-60.3). GPT-4o's performance in USMLE disciplines, clinical clerkships, and clinical skills indicates substantial improvements over its predecessors, suggesting significant potential for the use of this technology as an educational aid for medical students. These findings underscore the need for careful consideration when integrating LLMs into medical education, emphasizing the importance of structured curricula to guide their appropriate use and the need for ongoing critical analyses to ensure their reliability and effectiveness.

Reinforcement of Core Foundational Science Concepts during Clinical Rotations: A Strategy to Enhance Medical Student Learning and Diagnostic Reasoning.

Cognitive science principles can facilitate integrating and retaining basic science concepts during the clinical years of undergraduate medical education. We hypothesized that reinforcing foundational science concepts during the core clerkship experiences fosters the development of clinical reasoning in medical students. A patient simulation session on diabetic ketoacidosis (DKA) in the pediatric clerkship was chosen to pilot the program. We introduced an intervention in which a team of clinical and foundational science faculty facilitates student discussions, helping them connect important physiological and pathophysiological concepts to the disorder's clinical presentation, diagnosis, and management. The student survey reported that 87% strongly agreed that it helped them reinforce their understanding of foundational science concepts related to clinical cases. The NBME subject exam results of the pediatric clerkships from the corresponding years were subjected to a cognitive diagnostic assessment called the DINA model analysis. The student content mastery in acid-base disorders was improved following the intervention (student mastery of skills, 0.73 vs 0.80, P=0.035). Similarly, analysis of the Step 2 Clinical Knowledge (CK) skills from the NBME subject exam item analysis reports showed improvement in the skill "diagnosis" on the topic of diabetes (probability value- before and after the intervention, respectively, 0.73 and 0.85, p=0.04) following implementation. Our study shows the impact of foundational science reinforcement during clinical clerkships in developing undergraduate medical students' clinical reasoning and diagnostic skills.

Impact on dental hygiene students’ adaptation of clinical clerkship

Objectives: This study was conducted to determine the degree and relationship between dental hygiene students’ Interpersonal skills, adaptation of university life, and adaptation of clinical clerkship. Methods: Data were collected from December 15, 2023 to 30, and the final analysis subjects were 180 people. Results: Factors affecting clinical clerkship adaptation of dental hygiene students were department satisfaction and university life adaptation, and the explanatory power was 25.7%. Conclusions: It is believed that a program to improve adaptation to college life with professors and seniors is necessary to help students become interested in and adapt to college life, and that clinical training is necessary for students preparing for practicum.

Going back to anatomy roots: Exploring the integration of anatomy sessions during clinical clerkships.

The topic of vertical integration of the basic and clinical sciences is an area of great concern and active investigation in medical education. To explore the feasibility of integrating basic sciences into the clinical phase of medical education, gross anatomy was selected as an appropriate discipline. Anatomy faculty, clerkship directors, medical students, and graduate students developed case-based anatomy modules with a design consistent with the principles of self-directed learning. This pilot study aimed to explore medical student responses to the integration of anatomy sessions during clinical clerkships. One-hour anatomy sessions were conducted during rotations of the following clerkships: internal medicine, pediatrics, family medicine, neurology, obstetrics and gynecology, and general surgery during the academic year 2022-2023. Each session consisted of four case-based stations. Voluntary, anonymous surveys were distributed at the end of each session. Descriptive statistics of survey responses from the 490 participants revealed the overall ratings of the anatomy sessions to be above an 8.50 on a scale of 1.00 (low) to 9.00 (high). A small q thematic analysis of the open-ended survey questions revealed the following themes: relevance of clinical correlations presented, a timely review of anatomical content, appreciation for the collaborative setting and interactivity among the participants, and constructive feedback regarding areas needing improvement. Students reported a high overall rating of the anatomy sessions and shared positive comments about these vertically integrated anatomy experiences. With a reduction in the amount of anatomy instruction during the pre-clinical years and limited exposure during the clinical years, anatomy sessions like the ones proposed could allow for the fluid incorporation of gross anatomy across all 4 years of medical school.

Integrating Simulation-Based Education Into Regional Clinical Clerkship for Future Doctors: A Narrative Review

Integrating Simulation-Based Education Into Regional Clinical Clerkship for Future Doctors: A Narrative Review

Calculating the Notional Learning Hours (NLH) for Final-year Medical Students in a Clinical Surgery Clerkship Course

Background: The main objective of this study is to design a method to calculate the notional learning hours (NLH) of final year medical students doing a surgical clerkship course. Secondary objectives include derivation of the Oman Qualification Framework (OQF) credits and setting a benchmark of NLH in clinical courses.Methods: This is an observational cross-sectional study which uses a quantitative way to estimate students’ NLH. A questionnaire was designed and filled by final year medical students at the end of their surgical rotation. Ethical clearance was obtained. The data were uploaded and analyzed using SPSS 25. The NLH was then calculated and mapped on the OQF template.Results:Ninety-seven students participated in the study. Students spent an average of 1.20 (0.99) hours/day to study their clinical sessions and 2.86 (1.4)/day to study for their theory sessions. The mean weekend hours of study on Friday and Saturday were 3.1 hours (2.6), and 3.2 hours (2.5), respectively. The average preparation for the end rotation and the final MD exams were 9.7 (3.3) and 10.4 (3.6) hours, respectively. We calculated the NLH of our students by adding the above data to the contact teaching hours from our course timetable. We compared our results with worldwide medical schools.Conclusion: The NLH of our surgical clerkship students was calculated and subsequently the OQF credits were derived. This suggested method is evidence-based and could be used as a guide by other clinical clerkship courses.

Students’ perceptions of fairness and accuracy in clinical practice evaluation

Objectives: This study aims to investigate dental students' perceptions regarding the evaluation of clinical practice and to explore the factors influencing these perceptions.Methods: An online survey was conducted targeting third and fourth-year dental students from 11 nationwide dental schools. The survey focused on their perceptions of the accuracy and fairness of two clinical practices: 1) clinical clerkship in specialty clinics, and 2) direct patient care in pre-doctoral treatment centers. Additionally, the effects of different clerkship models (disciplinary block, longitudinal integrated), evaluation units (individual subject, integrated subject), and grading systems (grading, pass/fail) were assessed.Results: The overall perception of fairness and accuracy in clinical practice evaluation was found to be low. Students in disciplinary block clinical practice settings reported lower perceptions of evaluation accuracy and fairness compared to those in longitudinal integrated or mixed schedule types. Furthermore, the grading system influenced the perception of fairness and accuracy in the evaluation of clinical practices. Regarding direct patient care in pre-doctoral treatment centers, the evaluation units significantly impacted students' perceptions, although the grading system did not. Groups with grading systems showed lower perceptions compared to those with pass/fail or mixed evaluation systems.Conclusion: The study reveals that dental students perceive clinical practice evaluations as generally unfair and inaccurate, particularly within disciplinary block schedules. To improve future dental education, adopting longitudinal integrated schedules could be considered to enhance the perceived fairness and accuracy of clinical practice evaluations.

A comparison of approaches to teaching clinical skills

Background: The most appropriate timing and mode for teaching clinical skills as preparation for medical students’ clinical rotations or clerkships is not widely agreed upon. Increasing pressure on placement opportunities has led to a shift towards simulation-based teaching in the early years of medical training. Approach: A major curriculum renewal provided an opportunity for comparison of the effectiveness of a largely ward-based (early patient exposure) curriculum with a largely simulation-based one in preparing students for clinical rotations. Evaluation: We surveyed students from two different programs and invited them to take part in voluntary objective structured clinical examinations (OSCEs) to compare their skills and self-reported preparedness. Qualitative data was also collected from focus groups with a small number of students. Implications: The findings suggest that the more structured, simulation-based curriculum is at least equivalent to the ward-based approach in teaching clinical skills and preparing students for clinical rotations. Students’ clinical reasoning skills could be enhanced in a simulation-based curriculum through more explicit training to prepare them for being asked questions on clinical placement.

Clinical Clerkship With or Without Scheduled Patient Consultations: Does It Make a Difference to Medical Students’ Experiences of Learning?

Abstract Background Becoming a medical expert involves leadership and professionalism, which are critical skills to learn in medical education. However, a gap exists in understanding how didactic variations in the organisation of clinical clerkships impact medical students’ opportunities to develop these skills. This study explored how clinical clerkships with or without scheduled patient consultations affect medical students’ experiences of learning leadership and professional behaviour. Materials and Methods We conducted a qualitative, quasi-experimental study. Data were gathered through 11 end-of-clerkship focus group interviews with 87 fifth-year medical students who participated in one of two 8-week clerkships at a surgical department: a clerkship with a mentor physician or a clerkship with scheduled patient consultations in combination with a mentor physician. Using a constructivist lens, we analysed the focus group interview transcripts and applied grounded theory principles to the iterative coding process. Results The analyses resulted in a descriptive framework displaying nine themes. Each theme was described as a spectrum of meanings that offers a nuanced understanding of how didactic variations in the organisation of clerkship impact how students ascribed meaning to the learning experiences in undergraduate medical education, focusing on learning leadership and professional behaviour. Discussion This study investigates differences in student learning experiences when participating in a clerkship with or without scheduled patient consultation and, therefore, adds new insight into the need for a balanced, thoughtful, and didactic approach to medical education that considers both clinical exposure and co-regulated learning.

Librarian and Clinical Faculty Collaborative Use of Formative Assessment in a Longitudinal Evidence-Based Medicine Curriculum

Background The authors developed a longitudinal curriculum for teaching third- and fourth-year undergraduate medical students evidence-based medicine (EBM). This curriculum involved substantial librarian involvement, the use of formative assessment as a teaching method, and progressive repetition of skills. Methods Students in three clinical clerkships (Medicine, Pediatrics, OB/GYN) completed EBM assignments based on real-world scenarios in this quasi-experimental study. Each clerkship required students to submit an EBM plan, from which they received directed feedback from both the clerkship director and a librarian after submitting preliminary EBM plans. This study tracked student PICO and search submissions to determine if repeated exposure to EBM feedback resulted in improved summative assessments, both in isolation and longitudinally. Results Students’ PICO and searching performance improved between mid-clerkship formative feedback and end-clerkship summative assessment in all three clerkships using rubrics developed by the authors for each clerkship derived from existing literature. When examining student performance sequentially over three clerkships, there was significant improvement between the first and second clerkships, but this did not carry into the third clerkship. Discussion Our findings suggest that the significant inclusion of a librarian and feedback appears to have positive effects on student performance. While it may seem obvious that feedback results in improved outcomes, this method doesn’t appear widespread in medical education. Repetition, while not having a lasting increase in performance, may still be warranted to increase exposure to authentic cases and evidence types.

Augmented Reality-Guided Mastoidectomy Simulation: A Randomized Controlled Trial Assessing Surgical Proficiency.

Mastoidectomy surgical training is challenging due to the complex nature of the anatomical structures involved. Traditional training methods based on direct patient care and cadaveric temporal bone training have practical shortcomings. 3D-printed temporal bone models and augmented reality (AR) have emerged as promising solutions, particularly for mastoidectomy surgery, which demands an understanding of intricate anatomical structures. Evidence is needed to explore the potential of AR technology in addressing these training challenges. 21 medical students in their clinical clerkship were recruited for this prospective, randomized controlled trial assessing mastoidectomy skills. The participants were randomly assigned to the AR group, which received real-time guidance during drilling on 3D-printed temporal bone models, or to the control group, which received traditional training methods. Skills were assessed on a modified Welling scale and evaluated independently by two senior otologists. The AR group outperformed the control group, with a mean overall drilling score of 19.5 out of 25, compared with the control group's score of 12 (p < 0.01). The AR group was significantly better at defining mastoidectomy margins (p < 0.01), exposing the antrum, preserving the lateral semicircular canal (p < 0.05), sharpening the sinodural angle (p < 0.01), exposing the tegmen and attic, preserving the ossicles (p < 0.01), and thinning and preserving the external auditory canal (p < 0.05). AR simulation in mastoidectomy, even in a single session, improved the proficiency of novice surgeons compared with traditional methods. NA Laryngoscope, 2024.

Implementing Telemedicine into Clinical Training Through Pre-recorded Video Consultations

Although the contribution of real patient encounters to medical education is well known, challenges such as a lack of suitable cases, patients not consenting to student involvement, physical space limitations that prevent every student from participating, the inability to replicate the same patient encounter, and reduced patient admissions to healthcare facilities during extraordinary periods are common obstacles that need to be addressed in clinical education. To overcome these challenges, video consultation (VC) recordings, which were made with the consent of patients having a telemedicine consultation, were collected as an archive of medical interview recordings covering a wide spectrum of pulmonary diseases. These recordings were watched by students in a classroom setting during clinical clerkships, with case discussions interspersed. This article, which also discusses the results of clinical clerkship evaluations, indicates that the use of pre-recorded VC sessions can be an effective tool for teaching good clinical practices through the ideal method of medical interviews, diagnostic approaches, evaluation of test results, communication skills with patients and their relatives, and addressing the socio-psychological aspects and social impacts of diseases. As an innovative attempt, sharing this process at an early stage of development may inspire enthusiasm for implementing this approach and open the field for further development.

Changing Medical Student Perceptions of Mental Illness Through a Psychiatry Clinical Clerkship: A Longitudinal Qualitative Study

Abstract Objective This study sought to understand whether perceptions of mental illness change during the course of students’ psychiatry clerkships, and what facilitates such change. Methods Using a longitudinal qualitative study design, the authors followed up 14 medical students, interviewing them before, during, and after their psychiatric clerkship. Results Prior to clerkships, students perceived psychiatric patients to be dangerous, fragile, hard to treat, and to exert a disproportionate emotional toll on clinicians. Stigma was reinforced by safety measures including the provision of alarms, but this improved following “real life” engagement with patients. Students experienced little emotional distress from clinical contacts, particularly those where they led the consultation. Pre-existing beliefs about mental illness being hard to “fix” showed less change over time. Although uncommon, when staff referred to patients using pejorative language, students emulated these negative attitudes. Conclusions Among medical students, direct patient contact plays an important role in counteracting pre-existing negative attitudes towards mental illness. This can be facilitated by supportive supervisors, clinical teams allocating students a clear practical role, involving patients in teaching, and roleplay to alleviate potential concerns about seeing patients.

Imprecise Clinical Assessments and Inaccurate Grades: Family Medicine Clerkship Director Perspectives.

As application to residency programs becomes increasingly competitive, educational leaders face growing student concern about imprecise clinical assessments and clerkship grades. As part of a large annual survey of family medicine clerkship directors (FMCDs), 10 questions were disseminated in May 2023 about perceived levels of imprecise assessments by faculty. We aimed to determine to what extent respondents felt their institution's evaluation system propagated inaccurate grading. A total of 52% of 169 FMCDs responded to the survey. Of these, 7% of respondents were completely confident that their preceptors would give two students of identical competence the same clinical evaluation rating. FMCDs estimated that an average of 38% of their preceptors inaccurately rate student performance. Most clerkships use an Honors/High Pass/Pass/Fail grading system. We found that 51% of FMCDs prefer to use a different grading paradigm than they currently use. We asked FMCDs to estimate the percentage of students that expressed concern over inaccurate preceptor ratings. Grading systems with more tiers were associated with a higher percentage of concerned students. Clerkship grades are widely used by residency program directors to classify and differentiate student applicants. We identified a significant concern from FMCDs that clinical evaluation ratings can vary greatly. Given the high stakes and perceived inaccuracy of clerkship grading, we recommend continued investigation into the appropriate weighing and usage of clinical evaluations. Continued exploration is recommended to develop grading paradigms centered on criterion-based assessment.

Live Streaming of the Professor's Ward Rounds in Undergraduate Neurology Education: Usability Study.

Although neurology department ward rounds are among the most important medical education exercises in Japan, they have several issues. Patients may find it unpleasant to undergo repeated neurological tests, especially when in the presence of several students. Only the front row of students can closely observe the examination findings; moreover, students were prohibited from contacting patients altogether during the COVID-19 pandemic. One possible solution is to use commercial videoconferencing systems. However, Japanese patients are reluctant to have their medical information or video footage of them sent outside of the hospital via the internet. The study aimed to confirm the feasibility of conducting remote teaching rounds using an in-house web conferencing system in which the patients' personal data are securely protected. This study also explored whether using remote rounds alongside face-to-face participation would enhance learning. We created an on-premises videoconferencing system using an open-source app. To perform video ward rounds, the professor wore a wireless microphone while leading routine in-person rounds and the attending physician carried a tablet device linked to a web conference, allowing students in another room to watch the rounds on a live stream. In total, 112 of 5th-year students who entered their 1-week neurology rotation between 2021 and 2022 were instructed to participate in 1-hour in-person and remote rounds. Students were given questionnaires to evaluate their satisfaction and the educational effects of the remote rounds. The remote ward rounds were conducted easily with no interference with the in-person rounds, nor any complaints from the patients. Each examination technique was explained by another teacher to the students who participated in remote rounds in the conference room. Characteristic neurological findings, such as plantar reflexes (Babinski sign), which are usually seen only by close observers during in-person rounds, could be visualized under magnification by all students. The postexperience survey (82/112, 73% response rate) showed that the mean score of participants' satisfaction was 3.94 (SD 0.83; excellent 5 and poor 1). No participant scoring 1 was noted. The proportion of students who observed 6 representative abnormal neurological findings (Babinski sign, hyperreflexia, cerebellar ataxia, involuntary movement, muscular weakness, and abnormality in sensory examination) increased by 22% (18/82, range 13-24) compared to in-person rounds alone. When self-rating the learning value, 43% (35/82) of the students answered that remote rounds are equally as valuable as in-person rounds, while 32% (26/82) preferred remote rounds. Live-streaming of neurology ward rounds using a secure in-house web conferencing system provides additional learning experience without concerns regarding leakage of patient information. This initiative could enhance neurology learning before entering a clinical clerkship.

Intimidating Attendings: The Importance of Near-Peer Mentorship During Third-Year Surgical Clerkship

IntroductionNear-peer instruction has grown in popularity in medical education; however, limited data exist to support its effectiveness. This study investigates the perceptions of near-peer style instruction in third-y medical students undergoing a surgical clinical clerkship. We hypothesized that near-peer instruction would provide a beneficial educational experience to third-y medical students during their surgical clinical clerkship. MethodsThe authors anonymously surveyed third-y medical students undergoing their clinical clerkship in surgery on their perception of the near-peer instruction and mentorship they received from fourth-y medical students at the beginning of the clerkship. Near-peer instruction included teaching suturing techniques, surgical procedures and anatomy, operating room literacy, and sharing anecdotal experiences. Surveys were distributed 24 h after receiving the formal instruction. ResultsA total of 85 students completed the survey (78% response rate). Students reported a similar or increase in value of learning from near-peer mentors compared to attending physicians (less valuable: 1.2%; just as valuable: 52.9%; more valuable: 45.9%). The majority of students indicated they would like to experience more near-peer style instruction in medical school as demonstrated in surgical clerkship training (absolutely no: 0%; probably not: 0%; on the fence: 4.7%; probably yes: 25.9%; absolutely yes: 69.4%). After experiencing near-peer instruction and mentoring, students were more interested in becoming near-peer mentors (less interested: 1.2%; just as interested: 29.4%; more interested: 69.4%). ConclusionsStudents appreciate and desire near-peer instruction, seeing it as an effective learning method. Mentees undergoing near-peer style instruction have an increased interest in becoming near-peer mentors.

Factors associated with medical students’ career choice in different specialties: a multiple cross-sectional questionnaire study at a German medical school

BackgroundGiven the shortage and unequal distribution of physicians across specialties, we aimed to evaluate factors associated with medical students’ career choices, including background, personality traits, educational experience, personal interests, lifestyle considerations, and the awareness of work requirements.MethodsWe conducted multiple cross-sectional surveys of students; a 159-item online questionnaire was designed and students from three different stages of the six-year medical degree course (outset, clinical phase, and on graduation) were invited to complete the survey. Data were collected between May 2021 and April 2023.ResultsThe questionnaire was sent to 1406 students, of whom 683 replied (49%); 481 respondents were female (70%). The top specialty choices across the respondents were internal medicine, surgery, and general practice, with anaesthesiology, paediatric and adolescent medicine (ranging 11–15%), and obstetrics and gynaecology also receiving interest, with 6% undecided. In particular, female students lost interest in surgery during the course of study in favour of the other options. The choice of general practice was associated with more vocational training, prior positive experiences with the specialty, and lower grades in the university entry examination. Clinical clerkships in a specific (freely chosen) specialty aligned with career choice, while the final practical year did not have an impact on career decision-making. All students highly desired regulated working hours and work-life-balance; however, students choosing surgery rated these items as less important. Willingness to work in a hospital environment was highly associated with choosing anaesthesiology and surgery, whereas rural areas and practices were associated with general practice. Higher scores at agreeableness were associated with choosing paediatric and adolescent medicine by more female students, whereas lower neuroticism values were associated with the choice of anaesthesiology.ConclusionsThe results highlight the intricate nature of decision-making and shed light on various aspects that contribute to the process of selecting a specialty. By identifying and addressing influencing factors, we can develop targeted interventions and policies to enhance diversity and distribution across medical specialisations and to aim for high-quality and equitable healthcare that matches the specific needs of both individuals and the population as a whole.Graphical

Innovations report: A grading committee for a required fourth-year emergency medicine clerkship.

Assessment of medical students in the clinical learning environment is fraught with challenges. Seemingly small variations in clinical clerkship evaluation can significantly impact a student's future. As such, the integrity of the grade selection process must be heavily scrutinized. Group decision making in the form of a clerkship grading committee may be part of a solution to address this complex problem. We conducted a retrospective observational study to describe grading committee decisions for a required fourth-year EM clerkship from August 2021 to April 2022. Literature on best practices for group decision making and assessment were reviewed. This informed the development and implementation of the committee process. Each committee meeting was video recorded and coded for discussion time per student, times the committee grade differed from historical-grade cutoffs with reasoning, and the frequency a committee member voiced a first-hand account of student performance. Data from nine meetings was reviewed (86 students). The mean discussion time per student was 2 min 13 s (range 11 s to 9 min 22 s). The final committee decision differed from historical-grade cutoffs for nine students (10%), six were adjusted above and three below. In 64% (55/86) of student reviews a committee member voiced a first-hand experience of working with the student. Positive grade adjustments were made due to outlier evaluations and negative adjustments were made for professionalism concerns. Grading committees are a means to conduct a comprehensive review of student performance and offer shared ownership of the grade decision among committee members. More study is needed to directly determine their potential benefit and role in clerkship grading.

INFLUENCE OF MANAGEMENT OF CLERKSHIP TRAINING ON STUDENTS’ ACQUISITION OF CLINICAL SKILLS IN MBALE CITY HEALTH TRAINING INSTITUTIONS, UGANDA.A CROSS-SECTIONAL STUDY.

Background: This study focused on assessing the influence management of clerkship training on Students’ Acquisition of Clinical Skills in Health Training institutions in Mbale City. Methodology: The study adopted the cross-sectional design with a sample of 124 respondents from the medical staff in Mbale Regional Referral Hospital, Data was collected using questionnaires and interview guides for quantitative and qualitative data respectively. Data was analyzed using SSPSS software and content analysis respectively. Results: Th study targeted 127 respondents but got a response rate of 124 participants and among these, nurses comprised 53(44.2%) of the sample, 46(38.3%) were Allied Health, 13(10.8%) were Midwives while 8(6.7%) were medical officers. The duration planned for clinical clerkship training is appropriate to promote students’ skills acquisition (Mean=2.11, Standard deviation=0.994). The decision rule is that the calculated p-value (level of significance) must be less than or equal to 0.05. Since the calculated p-value of 0.000 is less than 0.05, the regression model was found to be statistically significant (F=105.838, Df=1, ρ&lt; 0.05, β=0.688) hence the Management of the Clerkships Training positively influences Students’ acquisition of clinical skills. Conclusion: Management of the Clerkships has a significant positive influence on Students’ acquisition of clinical skills. This was interpreted to mean that if Health Training Institutions in Mbale City enhance on Management of the Clerkships, there will be a positive enhancement in Students’ acquisition of clinical skills. Recommendation: Health Training Institutions in Mbale City should work more towards boosting the Management of the Clerkships towards supporting Students’ acquisition of clinical skills.

Using the electronic health record to provide audit and feedback in medical student clerkships.

This article focuses on the role of the electronic health record (EHR) to generate meaningful formative feedback for medical students in the clinical setting. Despite the scores of clinical data housed within the EHR, medical educators have only just begun to tap into this data to enhance student learning. Literature to-date has focused almost exclusively on resident education. Development of EHR auto-logging and triggered notifications are discussed as specific use cases in providing enhanced feedback for medical students. By incorporating predictive and prescriptive analytics into the EHR, there is an opportunity to create powerful educational tools which may also support general clinical activity. This article explores the possibilities of EHR as an educational resource. This serves as a call to action for educators and technology developers to work together on creating health record user-centric tools, acknowledging the ongoing work done to improve student-level attribution to patients. EHR analytics and tools present a novel approach to enhancing clinical clerkship education for medical students.