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1.  Educational and Career Outcomes of an Internal Medicine Preceptorship for First-Year Medical Students 
Medical educators have attempted in recent years to provide quality clinical experiences for medical students early in their medical training. We questioned whether participating in a preceptorship in internal medicine (PIM) resulted in better performances on subsequent clinical rotations and increased interest in internal medicine.
Fifty-four students have participated in the PIM to date, with control groups consisting of students who applied for it but were not selected (n = 36), students participating in a preceptorship in family medicine (n = 168), and the remaining students (n = 330).
Prospective cohort study.
University medical center and community practices.
A 2-month, clinical preceptorship following the first year of medical school.
The following outcomes were assessed: scores in the introduction to clinical medicine course; grades in the medical ethics course; scores from the internal medicine clerkship; and choosing a career in internal medicine. In their second year, PIM students scored higher in both semesters of the introduction to clinical medicine course (87% and 86% vs 84% and 84%, p’s < .01) and were more likely to receive honors in ethics (50% vs 29%, p < .01) than non-PIM students. During the internal medicine clerkship, PIM students’ scores were significantly higher on an objective structured clinical examination (79% vs 76%, p = .05), ambulatory clinical evaluations (80% vs 76%, p < .01), and overall clerkship scores (78% vs 75%, p = .03) but not on inpatient clinical evaluations or on the National Board of Medical Examiners Subject Examination. Preceptorship students were more likely to receive honors grades in the medicine clerkship (33% vs 10%, p < .01), and they were more likely to match into internal medicine residencies than control students (54% vs 27%, p < .01).
The PIM course is an intervention, early in students’ careers, which appears to benefit them academically and increase their interest in internal medicine as a career.
PMCID: PMC1496599  PMID: 10354253
medical students; clinical competence; curriculum
2.  Oral Versus Written Feedback in Medical Clinic 
To determine whether residents perceived oral, face-to-face feedback about their continuity clinic performance as better than a similar, written version.
Single-blind, randomized controlled trial.
Two university-based, internal medicine residency clinics.
All 68 internal medicine and combined program (medicine-pediatrics, medicine-psychiatry, medicine-neurology, and preliminary year) residents and their clinic preceptors.
Residents at each program were separately randomized to oral or written feedback sessions with their clinic preceptors. The oral and written sessions followed similar, structured formats. Both groups were later sent questionnaires about aspects of the clinic. Sixty-five (96%) of the residents completed the questionnaire. Eight of the 19 questions dealt with aspects of feedback. A feedback scale was developed from the survey responses to those eight questions (α= .86). There were no significant differences in the responses to individual questions or in scale means (p >.20) between the two feedback groups. When each university was analyzed separately, one had a higher scale mean (3.10 vs 3.57, p = .047), but within each university, there were no differences between the oral and written feedback groups (p >.20).
No differences were observed between the oral and written feedback groups. In attempting to provide better feedback to their residents, medical educators may better apply their efforts to other aspects, such as the frequency of their feedback, rather than the form of its delivery.
PMCID: PMC1496929  PMID: 9541371
feedback; medical education; internal medicine; ambulatory care; residents

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