Performance of third-year medical students on a rural family medicine clerkship

In 1999 the University of Kansas School of Medicine established a rural option for the required family medicine clerkship to increase student exposure to rural locations. The emphasis at these sites was in experiential learning, and students did not attend lectures. To assure that students who chose the rural option were receiving an equivalent educational experience, we compared the performance of rural students to their peers that received the standard clerkship experience.

We used data from family medicine clerkship students during 1999--2011 to compare rural students with those that remained on the main campus. Comparison of the groups was made with regard to previous academic performance and demographic data to assess for initial differences. While the rural students were more likely to be Caucasian, there was otherwise no statistical significance between the groups. We then compared their National Board of Medical Examiners (NBME) exam performance and their overall grade.

Students who chose a rural location had a significantly higher clerkship grade. This was due to higher clinical evaluations.

Students who completed a rural family medicine clerkship are not at an academic disadvantage. There are many possible explanations for better clinical evaluations, and a comparison of performance on the clinical skills assessment would be useful to determine whether the increased clinical experience during the rural option created a difference in clinical skills.