title: Evaluation of an innovative pediatric clerkship structure using multiple outcome variables including career choice.
abstract: BACKGROUND
  Few studies have examined alternative structures for inpatient clerkships.
  
  
  OBJECTIVE
  Compare 2 inpatient clerkship structures using multiple outcome variables.
  
  
  METHODS
  Prospective, randomized controlled trial.
  
  
  METHODS
  Tertiary-care, freestanding children's hospital.
  
  
  METHODS
  All medical students enrolled in the third-year pediatric clerkship in the 2001-2003 academic years.
  
  
  METHODS
  A clerkship structure consisting of an academic attending, a third-year pediatric resident, and 4 third-year medical students, but no interns.
  
  
  METHODS
  Student end-of-rotation examinations, evaluations, a questionnaire, and career choices were used to evaluate the intervention. Patient logs and resource utilization were also assessed. Statistical analysis included evaluating differences between groups and measuring effect size.
  
  
  RESULTS
  Two hundred and three students were randomized. Compared with those on the traditional services, students on the intervention service encountered more key diagnoses in the patients they cared for (4.4 vs. 3.6, P < .01). These students also gave higher ratings to their overall attitude (4.48 vs. 4.26, P = .02) and input into patient care decisions (4.45 vs. 3.98, P < .01). More than twice as many students on the intervention service matched in pediatrics (OR 2.52, 95% confidence interval 0.99-6.38). Multivariate analysis of length of stay and total charges for selected patients revealed similar outcomes.
  
  
  CONCLUSIONS
  A third-year pediatric clerkship that focuses on students is associated with increased satisfaction, higher interest in pediatrics, and consistent resource utilization. The intervention, therefore, merits continuation, whereas further research is required to identify which aspects of the intervention are responsible for its positive effects.
authors: Division of Pediatric Inpatient Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA. armand.antommaria@hsc.utah.edu
authors: Armand H Matheny
authors: AH
authors: Antommaria
authors: Sean D
authors: SD
authors: Firth
authors: Christopher G
authors: CG
authors: Maloney
mesh_terms: D000328:Adult; D002321:Career Choice; D002982:Clinical Clerkship / Q000379:methods / Q000592:standards*; D005260:Female; D006801:Humans; D008297:Male; D009936:Organizational Innovation; D010372:Pediatrics / Q000379:methods / Q000592:standards*; D011446:Prospective Studies; D013337:Students, Medical