Easing the Transition to Clinic: An Approach to Preparing Students
September 10, 2020

Perspectives | September 10, 2020


By: Traci Marquis-Eydman, MD, FAAFP | Associate Professor & Director of the Maine Longitudinal Integrated Clerkship | Frank H. Netter MD School of Medicine at Quinnipiac University 

One of the most challenging transitions that medical students make is from the pre-clinical years to the clinical/clerkship years.  Students must make multiple, sometimes frustrating, adjustments in their ever-changing learning culture and environment, as well as in their approach to the mastery of content and application of knowledge to the clinical setting.  At the same time, there is a large emotional shift as they move ever closer to assuming physician-like roles and navigate their place on a care team.  This year, COVID placed additional challenges to this transition, by limiting student and faculty abilities to interact with each other in a physical space and have a free-flowing discussion of topics critical for students’ professional development at this point in their education.

Online Orientation Focused on Key Clinical Concepts

The traditional orientation week or time period provides educators with an opportunity to recognize this transition period, and to provide students with key concepts that will aid them in this shift in the learning environment, clinical knowledge integration, and view of self within a team and professional development.   

We created an Orientation Course for our Longitudinal Integrated Clerkship (LIC) students that addressed multiple concepts and facets of the transition to the clinical/clerkship years. Our course was created entirely by using Aquifer’s free interdisciplinary cases and Student Learning Resources, which are available to all subscribing faculty and students regardless of your program’s subscribed courses. The course included content on culture in healthcare and cultural awareness, diagnostic excellence (including an emphasis on patient safety and avoidance of medical errors), high value care, oral presentation practice, and advanced communication skills. Students were required to complete 15 modulesa combination of Aquifer’s cases and Student Learning Resources—across this spectrum of topics over a 10-day period of time, which included the 6 days that students spent in in-person orientation.  

Allowing students to complete these modules independently facilitated more time during orientation week for content that was felt to be best delivered in person, such as Basic Life Support Orientation, Expectations for Professionalism, extensive electronic medical record (EMR) training, mask fit testing, suture workshops, and SIM lab sessions, extensive procedure training, operating room preparation, and crucial time getting to know their faculty and the staff.  In addition, we intend to circle back on some of these key Orientation Module topics later in the Clerkship to emphasize crucial learning objectives, particularly in high-value care, patient safety, and diagnostic excellence.  

Adapting for the Future

Looking ahead to next year, we are hopeful that more in-person orientation and dialogue will be possible, and thus we may reduce the number of required orientation modules from 15 to 10 while still maintaining the breadth of the topics covered.  In addition, as Clerkship Director, I will host either an in-person or a Zoom discussion on selected cases to emphasize key points in high-value care and cultural awareness. Finally, I plan to survey the students before and after their orientation to gauge their perception of preparedness, and how each of the asynchronous and synchronous events played a role in this perception.

Editor’s Note: The author is pleased to share her curated list of Aquifer cases and Student Resources used in the orientation course described above.

Related Articles & Research

Godefrooij, M.B., Diemers, A.D. & Scherpbier, A.J. Students’ perceptions about the transition to the clinical phase of a medical curriculum with preclinical patient contacts; a focus group study. BMC Med Educ 10, 28 (2010). https://doi.org/10.1186/1472-6920-10-28

Prince KJ, Boshuizen HP, van der Vleuten CP, Scherpbier AJ. Students’ opinions about their preparation for clinical practice. Med Educ 2005;39 (7):704–12.

Teunissen PW, Westerman M. Opportunity or threat: the ambiguity of the consequences of transitions in medical education. Med Educ 2011;45 (1):51–9.

Surmon L, Bialocerkowski A, Hu W. Perceptions of preparedness for the first medical clerkship: a systematic review and synthesis. BMC Med Educ 2016;16:89.

Chumley H, Olney C, Usatine R, Dobbie A. A short transitional course can help medical students prepare for clinical learning. Fam Med 2005;37 (7):496–501.

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