Impact of Community-Based Clinical Clerkship on Medical Students' Generalism-Related Competences: A Mixed-Methods...

Area of Science:

• Medical Education
• Generalism Competency
• Community-Based Learning

Background:

• Japan's 2022 Model Core Curriculum (MCC) recommends three-week community-based clinical clerkships for generalism competency.
• Empirical evidence supporting the duration and effectiveness of these clerkships is limited.

Purpose of the Study:

• To evaluate the impact of a three-week community-based clinical clerkship on medical students' generalism competency.
• To analyze student learning processes during the clerkship using reflection sheets.

Main Methods:

• An explanatory sequential mixed-methods design was employed with fifth-year medical students (n=112).
• Students completed a three-week community-based clerkship.
• Self-assessed attainment of 18 MCC generalism learning objectives was measured pre- and post-clerkship.
• Daily reflection sheets (n=1680) were analyzed using content analysis.

Main Results:

• Significant increases in self-assessed scores were observed for all 18 generalism learning objectives (p < 0.001).
• Effect sizes for self-assessed gains ranged from small (d=0.37) to very large (d=1.40).
• Content analysis of reflection sheets yielded 539 codes across 16 objectives, indicating active student engagement with generalism concepts.

Conclusions:

• A three-week community-based clerkship demonstrated significant perceived gains in generalism learning objectives.
• Student reflections confirmed active engagement with diverse aspects of generalism in practice.
• Further multi-site studies are needed to determine the optimal duration for such clerkships.