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Does Reducing Clerkship Lengths by 25% Affect Medical Student Performance and Perceptions?
Seetha U Monrad1, Nikki L Bibler Zaidi, Larry D Gruppen
1S.U. Monrad is assistant dean of assessment, evaluation, and quality improvement and associate professor of internal medicine and learning health sciences, University of Michigan Medical School, Ann Arbor, Michigan; ORCID: 0000-0002-3374-2989. N.L. Bibler Zaidi is associate director of advancing scholarship, Office of Medical Student Education, University of Michigan Medical School, Ann Arbor, Michigan. L.D. Gruppen is professor of learning health sciences, University of Michigan Medical School, Ann Arbor, Michigan; ORCID: 0000-0002-2107-0126. D.J. Gelb is professor of neurology, University of Michigan Medical School, Ann Arbor, Michigan. C. Grum is professor of internal medicine, University of Michigan Medical School, Ann Arbor, Michigan. H.K. Morgan is associate professor of obstetrics and gynecology and learning health sciences, University of Michigan Medical School, Ann Arbor, Michigan; ORCID: 0000-0002-6674-5377. M. Daniel is assistant dean of curriculum and associate professor of emergency medicine and learning health sciences, University of Michigan Medical School, Ann Arbor, Michigan; ORCID: 0000-0001-8961-7119. R.S. Mangrulkar is associate dean for medical student education, associate professor of internal medicine and learning health sciences, and Marguerite S. Roll Professor of Medical Education, University of Michigan Medical School, Ann Arbor, Michigan. S.A. Santen was assistant dean of educational research and quality improvement, University of Michigan Medical School, Ann Arbor, Michigan, and now is senior associate dean of assessment, evaluation and scholarship of learning and professor of emergency medicine, Virginia Commonwealth University School of Medicine, Richmond, Virginia; ORCID: 0000-0002-8327-8002.
Shortening medical school clerkships by 25% did not negatively impact student performance or well-being. This study suggests that accelerating clinical education may be feasible without compromising student outcomes.
Area of Science:
- Medical Education
- Curriculum Development
- Student Outcomes
Background:
- Medical school curricula are evolving, with potential for simultaneous student cohorts in clerkships.
- The University of Michigan Medical School reduced clerkship duration by 25% to manage overlapping cohorts.
Purpose of the Study:
- To investigate the impact of reduced clerkship duration on student performance and perceptions.
- To determine if a 25% reduction in clerkship length affects National Board of Medical Examiners (NBME) subject exam scores, clinical skills exam performance, and student well-being.
Main Methods:
- Comparative analysis using one-way ANOVA and Tukey post hoc tests.
- Comparison of the 2016-2017 shortened clerkship cohort with 2014-2015 and 2015-2016 traditional cohorts.
- Evaluation of outcomes including NBME subject exam scores, clinical skills exams, clerkship evaluations, perceived stress, resiliency, well-being, and learning environment perception.
Main Results:
- No significant differences in NBME subject exam scores or clinical skills exam performance between shortened and traditional clerkships (compared to 2015-2016).
- Improved perceptions of clerkship quality in three shortened clerkships; no significant declines in learning environment perceptions.
- No significant differences in perceived stress, resiliency, or well-being.
Conclusions:
- Reducing clerkship duration by 25% appears feasible without adverse effects on the studied student outcomes.
- Empirical data suggest that accelerating clinical education may be viable.
- Further research may explore optimal clerkship durations.
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