Evaluating immediate and long-range effect of a geriatric clerkship using reflections and ratings from participants as students and as residents.

This article describes a longitudinal study developed to assess perceived usefulness of a mandatory geriatric clerkship from the perspective of junior students completing the newly initiated program in 1998-1999 and 1999-2000 and these same students as second- or third-year residents. End-of-clerkship student evaluations were compared with follow-up resident surveys of those same students to identify the utility of information provided and strengths and weaknesses of the initial course experience. Students participated in hospice, outpatient clinics, nursing homes, and transitional care venues during their clerkship experience at the Donald W. Reynolds Department of Geriatrics, College of Medicine, University of Arkansas for Medical Sciences. Two hundred eighty-five student evaluations were collected, and 143 resident surveys were returned. Quantitative and qualitative data from students and residents corroborated each other in identifying strengths and weaknesses of the clerkship. Hospice information was successfully incorporated into residency practice. In contrast, outpatient clinic, nursing home, and transitional care segments of the clerkship were perceived as inadequate. Survey responses validated faculty changes that were initiated in the following years. These changes use settings and patients that more accurately mirror those seen in typical resident encounters.

Implementing a mandatory geriatrics clerkship.

Due to the rapid growth in the proportion of U.S. citizens aged 65 and older (20% by 2030) it is imperative that U.S. medical schools train students who can provide quality care to the older population. Consequently, the objective of this paper is to report the experience of creating a 4-week, mandatory geriatrics clerkship for junior medical students. Funded by a grant from the Donald W. Reynolds Foundation, the University of Arkansas for Medical Sciences developed a mandatory, third-year clerkship in geriatric medicine. The clerkship included clinical experiences in outpatient clinics, transitional care units, nursing homes, hospice programs, and core didactic sessions. The sites for the clerkship were the University of Arkansas for Medical Sciences Hospital, the Central Arkansas Veterans Healthcare System Hospital, community nursing homes, and community hospice programs in Little Rock, Arkansas. The entire junior class of 135 students participated in the new clerkship. Students were assessed through a three-station Objective Structured Clinical Examination followed by a brief post- encounter examination and faculty preceptor evaluations collected from each clinical site. Students evaluated the clerkship through written evaluations and focus group discussions. This paper demonstrates that students acquired sufficient cognitive knowledge to satisfactorily complete the clerkship but did not highly value the experience.