Impact of a required third‐year family medicine clerkship on student self‐assessment of cognitive and procedural skills

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Abstract
It is increasingly important for medical educators both to identify the clinical skills all students should acquire and to measure learner acquisition of these skills. Self‐assessment by students is a valuable but infrequently reported tool for measuring skill acquisition. This study analyzed students’ self‐assessment of clinical skill acquisition during a 1‐month decentralized family medicine clerkship using university and community preceptors. Three hundred thirty‐eight clerkship students rated their pre‐ and postclerkship confidence in a list of procedural and cognitive skills. This information was analyzed for changes resulting from the clerkship experience, for differences between students assigned to university and community preceptors, and for differences among quarters of the year in which students took the clerkship. This family medicine clerkship produced highly significant changes in student confidence (p = .0001) for all skills. Students entering the clerkship during April through June had significantly greater confidence in most skills compared to those taking the clerkship at other times, whereas those taking the clerkship from July through September had significantly larger changes in most skills than those taking it during other quarters. Finally, there were nonsignificant differences between university and community sites for most skills. Overall, a 1‐month decentralized family medicine clerkship produced highly significant changes in student confidence in a variety of important cognitive and procedural skills.