No abstract available.
Clinical Clerkship*

Background: Professionalism is a core competency of physicians, identified as one of the learning outcomes for the Doctor of Medicine program. In all the efforts geared towards supporting students develop high standards of professionalism through the 4-year course of medical education, perhaps the greatest gap is in assessment. Objectives: The study aimed to determine how attitudes towards professionalism among medical students change during clinical clerkship, which attitudes change, and if these changes are associated with certain demographic factors and specific clinical rotations. Methodology: This is a cohort study with a baseline and three consecutive measurements of attitudes towards professionalism among students in a medical school as they rotated in the different clinical departments for the first semester of AY 2018-2019. A 36-item questionnaire based on a validated instrument was used. Frequency counts, means, percentages, paired t-tests, analysis of variance, and chi-square were used to analyze the data. Results: Overall, the attitudes towards professionalism among medical students were positive at baseline and did not significantly change through three consecutive clinical rotations. The scores were highest and most stable for altruism, accountability, and excellence. No association was found between any change in attitudes and certain demographic factors including age, gender, and pre-medical course, and specific clinical rotation. Conclusion No significant change in attitudes towards professionalism was found among fourth year medical students as they rotated through three consecutive clinical rotations. While many factors should be considered, this finding should prompt a comprehensive look at how clinical clerkship experiences actually educate for professionalism.
Professionalism ; Clinical Clerkship ; Attitude

This study analysed the correlation between student achievement and the result of medical licensure examination. To predict the result of pass or fail in the medical licensure examination we carried out a discriminant ana lysis by using following variables: year-wise student academic record and the result of integrative test scores. The prediction ratio was 83.6% and the statistical result is significant. Based on this result the formular of the discriminant score for sucess in medical licensure examination is as following: Z= -19.6372+(0.1812)xcredit of 4th year+(0.0441)xthe result of intergrative test scores. Being considered that the curriculum for seniors was consisted of as core clinical clerkships on the basis of main subjects and the items of medical licensure examination were selected from main subjects. The result is a matter of course. Therefore, it is recommended to put emphasis on core subject-oriented teaching and to strengthen core clinical clerkship to enhence the possiblity of success of medical licensure examination. Since the afore-mentioned discriminant score may predict success of medical licensure examination the school administration can decide to offer special programs for risk group students.
Clinical Clerkship ; Curriculum ; Humans ; Licensure, Medical*

If medical campus is composed of multi-campus, the standardization of the students' clinical clerkship is one of the major concerns in medical education, since it is very difficult to supervise the precise students' performances by the executive officers. To improve and to standardize the clinical clerkship, the objective structured clinical examination and the clinical skill test was done and its results were analyzed. On February 11, 2001, the 85 junior students of the College of Medicine, Hallym University, undertook the examinations with 10 items. Mean of the results was 72.73. There was no significant difference of scores according to sex, and group of examinees. There was significant difference according to the hospital of students' clerkship in spite of there was no significant difference of the scores of written examination and total score of clinical clerkship. There was a significant difference of experiences of clinical skills according to the hospital. There was a positive correlation between degree of experience of clinical skills and scores (r=0.3888). The most important factor influencing the scores is believed to be a experience of clinical skills in the hospital since it can be postulated that the students' ability was not different according to the hospital. Also the depth of the clinical skill was also may be another influencing factor to the scores. When students works in multi-campus hospitals, the professors or educational supervisors should check the clinical skills as the guideline indicated, for the standardization of the clinical clerkship.
Clinical Clerkship* ; Clinical Competence* ; Education, Medical ; Humans ; Schools, Medical*

PURPOSE: The aim of this study was to investigate correlations between medical student scores on 4 examinations: the written examination, clinical clerkship examination, clinical skill assessment, and graduation examination. METHODS: Scores for 51 students who entered Daegu Catholic Medical School in 2005 on the written examination, clinical clerkship examination, clinical skill assessment, and graduation examination were included. Correlations between the scores were analyzed statistically. RESULTS: The scores on the written examination showed a strong correlation with those of the clinical clerkship assessment (0.833) and graduation examination (0.821). The clinical clerkship assessment scores correlated significantly with graduation examination scores (0.907). In addition, clinical skill assessment scores correlated with the written examination (0.579), clinical clerkship examination (0.570), and graduation examination (0.465) scores. CONCLUSION: Overall, the correlation between the scores on the clinical clerkship examination and the written examination was more significant than the correlation between scores on the clinical clerkship examination and clinical skill assessment. Therefore, we need to improve the evaluation method for the clinical clerkship examination and clinical skill assessment.
Clinical Clerkship ; Clinical Competence ; Humans ; Schools, Medical ; Students, Medical

OBJECTIVES: This study aimed to investigate the effect of clinical clerkship-associated achievements, such as performance of procedures at the student clinic, observation, and attitude towards a clerkship, on the objective structured clinical examination (OSCE) scores of dental students graduating in restorative dentistry. MATERIALS AND METHODS: The OSCEs consisted of two stations designed to assess students' clinical skills regarding cavity preparation for a class II gold inlay and a class IV composite restoration. The clerkship achievements, consisting of the number of student clinical procedures performed, observation-related OSCE, and scores of their attitudes towards a conservative dentistry clerkship, were assessed. Correlation and multiple regression analyses were conducted. RESULTS: The correlation coefficient between the OSCE scores for cavity preparation for a class II gold restoration and clerkship attitude scores was 0.241 (p < 0.05). Regarding a class IV composite restoration, OSCE scores showed statistically significant correlations with the observation (r = 0.344, p < 0.01) and attitude (r = 0.303, p < 0.01) scores. In a multiple regression analysis, attitudes towards a clerkship (p = 0.033) was associated with the cavity preparation for a class II gold inlay OSCE scores, while the number of procedure observations (p = 0.002) was associated with the class IV composite restoration OSCE scores. CONCLUSIONS: The number of clinical procedures performed by students, which is an important requirement for graduation, showed no correlation with either of the OSCEs scores.
Achievement ; Clinical Clerkship ; Clinical Competence ; Dentistry ; Humans ; Inlays ; Students, Dental

The author has confirmed the legistical authorization of medical student's active participation in clinical practice for their learning. The possible approaches for innovation of clinical clerkship ar e described and are analized in view point of medical colleges and society. Listing of important clinical skills in order (content and level), legistration of student's clinical clerkship. Limitation of legal protection in clinical practice, training of regidents and follows for better student's clerkship, and spiritual support from patients, community and government is emphasized.
Clinical Clerkship ; Clinical Competence ; Humans ; Learning ; Students, Medical*

PURPOSE: A proper patient-physician interaction (PPI) creates rapport between doctors and patients and improves medical outcomes. The importance of PPI evaluation items was evaluated in each medical student in grades 3 and 4, before and after their clinical clerkship. METHODS: Six PPI evaluation guidelines (SEGUE, Kalamazoo Consensus, Calgary-Cambridge Guide, Macy guideline, 2 Korean Consortium guidelines) were selected and importance of each guideline was evaluated through the structured questionnaire in 73 pre-clinical clerkship (3rd-grade) and 78 post-clinical clerkship (4th-grade) medical students. RESULTS: The importance of medical communication items among total clinical performance, students-rated PPI portion was 21+/-9.7%. In SEGUE recommendations, 'Elicit information' was evaluated to be most important items before (58.3%) and after (65.8%) clinical clerkship. In Kalamazoo Consensus, 'Gathering information' was evaluated to be most important (49.3%/42.3%), same as in Calgary-Cambridge Guide (52.1%/56.4%) and Daegu Gyeongbuk Consortium (47.9%/43.6%). In the Macy guideline, 'Listening' was evaluated to be most important (28.8%/33.3%). In the Seoul Gyeonggi Consortium, 'Buidling relationships' was evaluated to be most important (23.3%/28.2%). CONCLUSION: In the 4th-grade post-clerkship medical students after clinical clerkship, importance of 'Gathering information' was evaluated to be less important, however, 'Giving information' and 'Understanding the patient perspective' was evaluated to be more important, compared to pre-clerkship students 3rd-grade students.
Clinical Clerkship ; Consensus ; Humans ; Students, Medical ; Surveys and Questionnaires

PURPOSE: We conducted objective structured clinical examinations (OSCEs) in medical students both before entering clinical clerkship and after finishing clinical clerkship for the purpose of evaluating the usefulness of OSCEs before clinical clerkship. METHODS: The subjects of the study comprised 77 3rd-year medical students who participated in a 2-week course of physical diagnosis before clinical clerkship, and 98 4th-year medical students who had completed their clinical clerkship. The OSCE consisted of 17 cases and 17 stations for the 3rd-year medical students, and 20 cases and 28 stations for the 4th-year students. We assigned 4 minutes and 30 seconds to each station. OSCE stations were duplicated at two sites and were performed twice. After the OSCE, we used structured questionnaires to survey the subjects for their opinions of the current process and the need for an OSCE. RESULTS: At the psychiatric station, which applied an identical scenario and checklists to both the 3rd- and 4th-year medical students, the mean score of the 3rd-year medical students was significantly lower than that of the 4th-year students. The correlation coefficient between OSCE score and cumulative performance grade of 3rd-year medical students (r=0.29) also was lower than that of 4th-year medical students (r=0.53). Over 80% of the 3rd-year medical students and over 90% of the 4th-year responded that an OSCE is necessary. However, around 70% of students preferred an OSCE for each clinical class during clinical clerkship, and only 33~38% of students preferred an OSCE as a final examination. Almost all students wanted to receive feedback after an OSCE. CONCLUSIONS: Performing an OSCE on 3rd-year medical students before they enter clinical clerkship provides better preparation for the clinical clerkship than an evaluation alone. We suggest that an OSCE should be used as a formative assessment in addition to a summative evaluation such as a final examination.
Checklist ; Clinical Clerkship* ; Diagnosis ; Humans ; Students, Medical* ; Surveys and Questionnaires

PURPOSE: To report the experience of OSCE performed as a summative assessment of the medical students in year 4 at Ewha Womans University. METHODS: Ninety-eight students took the twenty stations including 3 pairs of linked stations. We conducted duplicated OSCEs and each station runs 4 minutes 30 seconds. We analyzed the validity of stations, the reliability of duplicated OSCEs and the difference of scores according to the OSCE tools and categories. RESULTS: Mean OSCE score was 64.45+/-5.49 and Cronbach-alpha of total stations was 0.74. The scores between duplicated examinee groups and between duplicated evaluator groups were not different: the score of preceding examinee group was 63.3 and the later 65.7 (p=0.13), and the score of the first evaluator group was 64.6 and the second was 63.6 (p=0.16). However according to the individual analysis, 9 stations showed statistically discrepancies (p< 0.05) between duplicated evaluator groups. Regarding OSCE tools and categories, physical examination and skill categories did not show statistically significant differences between duplicated evaluator groups. OSCE scores showed moderate correlation with the cummulative performance grade in general (r=0.53, p< 0.01). CONCLUSIONs: OSCE could be regarded as a reasonable evaluating tool for the summative assessment after two years of clinical clerkship of the fourth year medical students. Analysis of the OSCE stations which was done individually and according to OSCE tools/categories helps to improve the OSCE more complete and the duplicated stations more coincident.
Clinical Clerkship* ; Female ; Humans ; Physical Examination ; Schools, Medical* ; Students, Medical