Problem-solving instruction during the clinical clerkship: description and preliminary evaluation of a programme

A clerkship programme in general surgery is described whereby students acquire factual knowledge about disease entities through independent learning rather than through formal teaching. The objectives of the programme are to promote problem-solving skills. It consists of clinical work (patient work-up, clinical rounds, participation in the activities in the operating room, out-patient clinic and emergency room) and of small-group tutorial sessions. The described programme has met with approval and satisfaction from both students and teachers. There were no significant differences in the average grades on the written and oral final examinations between the graduates of this clerkship programme and those of a traditional one. Independent learning and problem-solving instruction, which have been adopted by some medical schools in the preclinical phase of the curriculum, can be effectively implemented during the clinical phase as well.