title: Impact of a pre-clinical clinical skills curriculum on student performance in third-year clerkships.
abstract: BACKGROUND
  Research on the outcomes of pre-clinical curricula for clinical skills development is needed to assess their influence on medical student performance in clerkships.
  
  
  OBJECTIVE
  To better understand the impact of a clinical-skills curriculum in the pre-clinical setting on student performance.
  
  
  METHODS
  We conducted a non-randomized, retrospective, pre-post review of student performance evaluations from 3rd-year clerkships, before and after implementation of a clinical-skills curriculum, the Colleges (2001-2007).
  
  
  RESULTS
  Comparisons of clerkship performance data revealed statistically significant differences favoring the post-Colleges group in the Internal Medicine clerkship for 9 of 12 clinical-skills domains, including Technical Communication Skills (p < 0.023, effect size 0.16), Procedural Skills (p < 0.031, effect size 0.17), Communication Skills (p < 0.003, effect size 0.21), Patient Relationships (p < 0.003, effect size 0.21), Professional Relationships (p < 0.021, effect size 0.17), Educational Attitudes (p < 0.001, effect size 0.24), Initiative and Interest (p < 0.032, effect size 0.15), Attendance and Participation (p < 0.007, effect size 0.19), and Dependability (p < 0.008, effect size 0.19). Statistically significant differences were identified favoring the post-Colleges group in technical communication skills for three of six basic clerkships (Internal Medicine, Surgery, and Pediatrics).
  
  
  CONCLUSIONS
  Implementation of a pre-clinical fundamental skills curriculum appears to be associated with improved clerkship performance in the 3rd year of medical school, particularly in the Internal Medicine clerkship. Similar curricula, focused on teaching clinical skills in small groups at the bedside with personalized mentoring from faculty members, may improve student performance. Continued efforts are needed to understand how to best prepare students for clinical clerkships and how to evaluate outcomes of similar pre-clinical skills programs.
authors.affiliation: Department of Medicine, University of Washington, 1959 N.E. Pacific St., Campus Box 356429, Seattle, WA 98195, USA. blackley@u.washington.edu
authors.forename: Molly Blackley
authors.initials: MB
authors.lastname: Jackson
authors.forename: Misbah
authors.initials: M
authors.lastname: Keen
authors.forename: Marjorie D
authors.initials: MD
authors.lastname: Wenrich
authors.forename: Doug C
authors.initials: DC
authors.lastname: Schaad
authors.forename: Lynne
authors.initials: L
authors.lastname: Robins
authors.forename: Erika A
authors.initials: EA
authors.lastname: Goldstein
mesh_terms: D002982:Clinical Clerkship / Q000379:methods / Q000592:standards* / Q000639:trends; D002983:Clinical Competence / Q000592:standards*; D003479:Curriculum / Q000592:standards* / Q000639:trends; D004504:Education, Medical, Undergraduate / Q000379:methods / Q000592:standards / Q000639:trends; D004521:Educational Measurement / Q000379:methods / Q000592:standards; D006801:Humans; D011231:Preceptorship / Q000379:methods / Q000592:standards; D015397:Program Evaluation / Q000379:methods / Q000592:standards; D012189:Retrospective Studies; D013337:Students, Medical