Experiential learning at a student-run free clinic is associated with improved performance on the clinical interviewing skills exam
Abstract
Purpose: To assess how medical student participation in a student-run free clinic impacts learning the core competencies of clinical decision making.
Background: Student-run free clinics provide experiential learning for future health professionals through clinical skill building and professional development. Measuring the impact on medical student education is necessary to assess the effectiveness of this pedagogical model. The CommunityCare Clinic (CCC) serves the primary, preventive, and tertiary health care needs of uninsured and underserved adults in Toledo, Ohio.
Methods: All first year medical students (n=177) at the University of Toledo College of Medicine and Life Sciences were emailed a 22-item electronic survey. Test-retest reliability (r=.90, p<.001) and internal consistency of the instrument (Cronbach’s alpha= 0.74) were strong. Student examination scores on the clinical interview skills exam in the Clinical Decision Making I course were reported and compared to number of CCC volunteer hours reported. Student confidence level on the Accrediting Council for Graduate Medical Education competencies in clinical interviewing skills were also compared to hours volunteered at CCC.
Results: We received 67 surveys for a response rate of 38%. The mean number of hours volunteered at CCC was 19 hours, corresponding to about two clinics time. Lack of time was the most frequently cited barrier to increased participation in CCC. An independent samples t-test compared high scorers on the clinical interviewing skills exam (those who scored above the 50th percentile) to low scorers on number of hours spent volunteering at CCC. There was a statistically significant difference (t(45)=2.5, p=.018) in number of hours volunteered between high scorers (M=21, SD=7.4) and low scorers (M=15, SD=7.9). There was no statistically significant relationship between clinical interviewing self-confidence rating, score on the clinical interviewing skills exam, and number of hours volunteered at CCC.
Conclusion: The results of our study suggests a positive relationship between the number of hours volunteered at a student-run free clinic and subsequent scores on the clinical interviewing skills exam. This survey is an adaptable assessment that can be applicable to other institution’s evaluation of experiential medical education. Further investigation into appropriate examination tools for assessing experiential learning is necessary.References
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