The impact of student ratings on a new course: the general clerkship (ALCO)

In 1980 a new course, called ALCO, was introduced in the faculty of Medicine at the University of Leiden. ALCO is the Dutch abbreviation of Algemeen Coassistentschap, which means general clerkship. This course was designed to bridge the gap between the first 4 years of theoretical studies and the subsequent 2 years of clerkship rotation. Because of the multidisciplinarity of the ALCO and the enormous amount of manpower required for this small-scale educational programme, the Faculty installed an Executive Board to oversee the course and the quality of instruction. By request of this Board the Department of Educational Research and Development set up a regular course evaluation, by having students fill out questionnaires, and reported annually on the outcome. This article presents a reconstruction of the dynamic process of the implementation of a new course in a traditional curriculum over a period of 5 years: on the one hand the impact of student ratings; on the other hand the changes made by the Executive Board in order to adjust the contents, format and methods of instruction. Now, after 5 years of ALCO, there is evidence that the student ratings, on the basis of which most decisions were taken, have contributed substantially to the instructional improvement of the ALCO.