Early clinical experience enhances third-year pediatrics clerkship performance

PURPOSE: To determine whether clinical experiences in the preclinical years improve medical students' performances in a third-year clerkship. METHOD: A cohort study reviewed the pediatrics clerkship performances of 400 Eastern Virginia Medical School students in the graduating classes of 1996 through 1999. The first two classes completed a traditional preclinical curriculum with limited clinical experience. The final two classes participated in a mentorship program that provided 18 months of early clinical experience, consisting of one-on-one half-day sessions every other week with a generalist community faculty. The authors compared the clinical clerkship performances of the groups using clinical skills (CS) scores, history and physical examination (H&P) scores, and scores on the NBME pediatrics shelf examination. They also looked at the mean MCAT and USMLE scores for each group. The authors also looked at the scores within each class, comparing students who completed one of the first two pediatrics clerkship rotations with their classmates who completed clerkships later in the academic year. RESULTS: The students' NBME scores rose significantly (p < .05, r2 = 0.95) over the four-year study, paralleling a significant rise in MCAT scores (p < .03, r2 = 0.73). The CS and H&P scores did not rise. Students who had the traditional preclinical curriculum and who completed their clerkships early in the year had significantly lower CS and H&P scores than did their classmates. In contrast, the scores of students who had the early clinical experiences did not differ significantly according to the timing of their rotation. CONCLUSION: Students who had participated in a mentorship program that provided early clinical experience demonstrated significantly improved clinical skills in the pediatrics clerkship early in the academic year.