The acquisition of cognitive knowledge through clinic experiences

The considerable amount of time that medical students spend in clinical encounters with patients implies an expectation of many educators and clinicians, based on little reported research, that cognitive knowledge will increase as a result. In this study, 119 junior medical students were assigned to various paediatric subspecialty clinics. Using a correlated t-test, students' performances on those written examination items that corresponded to subspecialty clinics attended were compared with their performances on items for clinics not attended. Attendance in the clinics was not found to enhance mean test performances significantly (t = 0.8; df = 113; P less than 0.21). However, significantly greater variation in test performance was observed for clinics attended than those not attended (t = 581.3; df = 112; P less than 0.001). Discussion includes possible reasons for these results, other benefits the students may have received, and implications for clinic teaching.