title: Clerkship directors' perceptions of the effects of managed care on medical students' education.
abstract: OBJECTIVE
  Little is known about the effect of managed care on medical students' education. Because clerkship directors (CDs) are especially well positioned to observe any changes, this study surveyed CDs from six medical specialties about their perceptions of the effects of managed care on medical students' education.
  
  
  METHODS
  Anonymous questionnaires were mailed to 808 CDs from departments of six medical specialties at 125 U.S. allopathic medical schools between October 1997 and March 1998. Among other questions, respondents were asked whether they had observed changes in 19 different aspects of medical students' education, whether these changes were beneficial or detrimental, and whether they believed the changes were due to managed care and/or to other factors. Results were analyzed to determine perceptions of the overall magnitude and source(s) of changes, the perceived positive versus negative effect of managed care, and whether these outcomes were statistically associated with the perceived degree of managed care's market penetration.
  
  
  RESULTS
  Five hundred questionnaires (61.9%) were returned. For full-time and voluntary faculty teaching, faculty availability for educational administration, directors' clinical responsibilities, and quality of professional life, the most common response was that managed care had an adverse effect. For faculty's enthusiasm for teaching, directors' administrative and educational duties, and clerkship training sites, the second most common response after "not changed" was that managed care had a negative effect. The majority of respondents held negative opinions of managed care and thought that medical students did not understand it.
  
  
  CONCLUSIONS
  CDs in six medical specialties perceived that managed care has negatively affected medical students' education. These perceptions may influence medical students' education. Measures must be taken to ensure excellent education through adequate resources and training in the context of high-quality medical care.
authors.affiliation: Department of Psychiatry, at the University of Pennsylvania, Philadelphia, USA. brodkeya@fast.net
authors.forename: Amy C
authors.initials: AC
authors.lastname: Brodkey
authors.forename: Frederick S
authors.initials: FS
authors.lastname: Sierles
authors.forename: Ilyse L
authors.initials: IL
authors.lastname: Spertus
authors.forename: Cindy L
authors.initials: CL
authors.lastname: Weiner
authors.forename: Fredrick A
authors.initials: FA
authors.lastname: McCurdy
mesh_terms: D001291:Attitude of Health Personnel; D002982:Clinical Clerkship; D006801:Humans; D008329:Managed Care Programs; D008511:Medicine; D013038:Specialization; D013337:Students, Medical / Q000523:psychology*; D011795:Surveys and Questionnaires; D013663:Teaching; D014481:United States