Alternating skills training and clerkships to ease the transition from preclinical to clinical training

The transition from preclinical to clinical training is perceived as stressful with a high workload being the main difficulty. To ease this transition, we implemented a dual learning year, where just-in-time skills training and clerkships alternated.

To examine the effect of the dual learning year on students' stress and perceptions of workload and skills level, and to compare these data with a baseline measurement from a curriculum in which skills training was provided in advance of clerkships.

During the first Master year, students completed four rotations in which 5 weeks of skills training and 5-week clerkships alternated. In the second clerkship week of each rotation, students (n = 476) completed questionnaires measuring their experienced workload, perceived skills level and stress. Analysis of variance was used for trend analysis and to determine differences with the baseline measurement (n = 83).

During the dual learning year, 'experienced workload' decreased (F(1,471) = 9.408, p < 0.01), 'perceived skills level' increased (F(1,471) = 94.202, p < 0.001) and stress decreased (F(1,471) = 3.309, p < 0.10). 'Experienced workload' was lower (F(5,553) = 7.599, p < 0.001) and 'perceived skills level' was comparable to the baseline measurement.

Compared to the baseline measurement and the results of earlier studies on transition difficulties, alternating just-in-time skills training and clerkships seem to ease the transition from preclinical to clinical training.