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Family medicine clerkships are frequently conducted in decentralized settings. Concerns have been raised regarding the educational consistency of such rotations. In this study, we assess learning across multiple training sites, as reflected by measures of student performance.The study population was 77 students assigned to six clusters of family medicine clerkship training sites during the 1993-1994 academic year. Learning, as measured by faculty evaluations, objective structured clinical examination (OSCE) performance, and Society of Teachers of Family Medicine (STFM) predoctoral examination performance, was compared for student cohorts assigned to each of the teaching site clusters using analysis of variance.No differences in OSCE or STFM examination performance were found across the teaching site clusters. Greater variation in faculty evaluation across sites was apparent, and when the academic and private practice teaching sites were compared with the HMO and community clinics teaching sites, this variation achieved statistical significance.As measured by OSCE and STFM examination performance, student learning did not vary across multiple training sites. However, greater variability was found in faculty evaluations of student performance. Sources of this variation might include differing levels of student-faculty interactions across sites or subjectivity inherent to the faculty evaluation process. |
