Expectations of and for clerkship directors: a collaborative statement from the Alliance for Clinical Education.

PURPOSE: The clerkship director (CD) is an essential leader in the education of medical students on clinical rotations. This article represents a collaborative effort of the national clerkship organizations that comprise the Alliance for Clinical Education (ACE), a multidisciplinary group formed in 1992. ACE suggests that selection of a CD be regarded as an implied contract between the CD and the department chair that each will take the steps to ensure the success of the clerkship and of the CD. This article sets standards for what should be expected of a CD and provides guidelines for the resources and support to be provided to the person selected for leadership of the clerkship. SUMMARY: In their roles as CDs, educators engage in three principal activities: administration, teaching, and scholarly activity, such as educational research. This article describes (a) the work products that are the primary responsibility of the CD; (b) the qualifications to be considered in selection of a CD; (c) the support structure, resources, and personnel that are necessary for the CD to accomplish his or her responsibilities; (d) incentives and career development for the CD; and (e) the dedicated time that should be provided for the clerkship and the CD to succeed. Studies by several CD organizations conclude that 25% should be considered a minimum estimate of time for the administrative aspects of running a clerkship. With the added teaching and scholarly activities undertaken by a CD, a minimum of 50% of an full-time equivalent has been recognized as appropriate. The complexity and the need for timeliness in the cyclic and often repetitive tasks of the clerkship require that a full-time administrative assistant be part of the structure dedicated to running the clerkship. CONCLUSION: ACE recommends that institutions have clear standards for what is expected of the director of a clinical clerkship and have correspondingly clear guidelines as to what should be expected for CDs in their career development and in the support they are given.

Have we met the educational challenges of obstetrics and gynecology? A response to the Association of Professors of Gynecology and Obstetrics Initiative of 1986.

OBJECTIVE: The purpose of this study was to assess the progress that has been made toward meeting the educational challenges in obstetrics and gynecology that were made at an Association of Professors of Obstetrics and Gynecology special forum in 1986. STUDY DESIGN: We placed the five major issues and specific problems that were identified within the context of developments that have occurred in medical education, the Association of Professors of Obstetrics and Gynecology, and the specialty over the last 15 years. We used the medical education literature and the accomplishments of the members of the Association of Professors of Obstetrics and Gynecology to measure progress. RESULTS: Many of the challenges that were raised at the original forum remain. Significant progress, much of it spearheaded by the Association of Professors of Obstetrics and Gynecology, has been made in the areas of teaching methods and skills, evaluation techniques, faculty development, computer usage, teaching recognition, counseling for the fourth-year student, and an integrated curriculum in women's health. CONCLUSION: Progress has occurred within the context and demands of a changing health care system that constricts the time and funding that are available for medical education.

The process of translating women's health care competencies into educational objectives.

"Women's Health Care Competencies for Medical Students" lists the competencies undifferentiated medical students should be able to demonstrate before graduation. The Association of Professors of Gynecology and Obstetrics (APGO) was among the groups asked to convert specified competencies into educational objectives. Working individually, APGO's Undergraduate Medical Education Committee members used APGO's Medical Student Educational Objectives, Seventh Edition, to construct objectives appropriate to preassigned competencies. Referring to the work of Miller, members determined the level of professional competence medical students should reach for each objective. Members also selected evaluation tools appropriate for the skill and its competency level from the Toolbox of Assessment Methods created by the Accreditation Council for Graduate Medical Education and the American Board of Medical Specialties. The group collectively revised the work of its members using a standard format to generate the final product.