Perceptions of preparedness for the first medical clerkship: a systematic review and synthesis

BMC Medical Education

Research Article

Wendy Hu¹  Laura Surmon¹  Andrea Bialocerkowski² 

[1] Medical Education Unit, School of Medicine, Western Sydney University, Bdg 30, Campbelltown Campus, Locked Bag 1797, 1797, Penrith South DC, NSW, Australia;School of Allied Health Sciences, Griffith University, Gold Coast, QLD, Australia;

关键词: Medical school;    Clerkship;    Transition;    Preparedness;    Clinical education;    Experiential learning;    Workplace based learning;    Informal learning;   

DOI  :  10.1186/s12909-016-0615-3

 received in 2015-11-24, accepted in 2016-03-09,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundThe transition from university-based to clerkship-based education can be challenging. Medical schools have introduced strategies to ease the transition, but there has been no systematic review synthesizing the evidence on the perceptions of preparedness of medical students for their first clerkship to support these interventions. This study therefore aimed to (1) identify and synthesize the published evidence on medical students’ perceptions of preparedness for their first clerkship, and (2) identify factors that may impact on preparedness for clerkship, to better inform interventions aimed at easing this transition.MethodsElectronic databases (Medline, Journals@Ovid, CINAHL, ERIC, Web of Science, Embase) were searched without restriction and secondary searching of reference lists of included studies was also conducted. Included studies used quantitative or qualitative methodologies, involved medical students and addressed student/supervisor perceptions of preparedness for first clerkship. The first clerkship was defined as the first truly immersive educational experience during which the majority of learning was vocational and self-directed, as per the MeSH term ‘clinical clerkship’ and associated definition. Using an inductive thematic synthesis approach, 2 researchers independently extracted data, coded text (from results and discussion sections), and identified themes related to preparedness. Any disagreements were resolved by discussion and findings were then narratively synthesized.ResultsThe initial search identified 1214 papers. After removing duplicates and assessing abstracts and full articles against the inclusion criteria, 8 articles were included in the review. In general, the body of evidence was of sound methodological quality. Ten themes relating to perceptions of preparedness of medical students for their first clerkship were identified; competence, disconnection, links to the future, uncertainty, part of the team, time/workload, adjustment, curriculum, prior life experiences and learning.ConclusionsEight of the ten themes related to perceptions of preparedness are potentially amenable to curricula strategies to improve the transition experience. The evidence supports clinical skills refreshers, clarification of roles and expectations, demystification of healthcare hierarchy and assessment processes and student-student handovers. Evidence also supports preclinical educational strategies such as enhancing content contextualization, further opportunities for the application of knowledge and skills, and constructive alignment of assessment tasks and pedagogical aims.

【 授权许可】

CC BY   
© Surmon et al. 2016