The development of cognitive knowledge in clinical clerkships

As part of an attempt to match the seminar program in pediatrics to the increased level of sophistication that students during the latter half of their core clerkship year would possess compared with students who enter pediatrics early in the year, the faculty of the Department of Pediatrics at The University of Texas Medical Branch in Galveston developed a typical final examination (a 100-item, multiple-choice test) and administered it as a pretest to each section of the junior class as it entered pediatrics. Analysis of the data indicated the following. A substantial portion of the cognitive information required for success in the clinical years was acquired prior to entry to the clerkship; scores of students entering their last clerkship were almost the same in the pretest in pediatrics as were those of students who took the pretest 10 monts earlier; posttest scores were substantially higher than pretest scores for all groups of students. The paper includes some discussion of the reasons for the findings and a description of the steps being taken to remedy deficiencies in the educational and evaluation program revealed by the study.