Transition to clerkship courses: preparing students to enter the workplace

Despite curricular shifts toward a clinically oriented first two years of medical school, students continue to struggle with the transition to clerkships. Transition courses are a curricular intervention to mitigate the challenges of entering clinical workplaces. The authors examine the objectives, content, educational strategies, and resources associated with transition courses.

The authors invited curricular deans and transition course directors at U.S. and Canadian medical schools to complete a Web-based survey in 2008. A prior qualitative study of transition courses informed the list of survey questions. The authors organize the key course features according to a preparation-for-workplace-learning framework and report the frequencies of course features based on descriptive statistics.

Of the 83 schools (58% response rate) responding to the survey, 73 (88%) reported having transition courses. Most courses covered content relevant to key elements of workplace learning: roles and expectations of clerks, advice from senior students, professionalism, stress management, and procedural skills. Whereas 65 courses (98%) used didactic sessions and 49 (74%) incorporated hands-on practice, only 14 (21%) included practice in clinical settings.

The intent of transition courses is to prepare students for workplace learning, but the most common approaches provide limited exposure to real clinical settings. Transition courses could better prepare students for workplace learning by increasing exposure to the routines, norms, and professionals that students encounter in clinical settings.