Individualization of Clerkship Teaching

In recent years medical educators have explored a number of educational techniques in an effort to improve current teaching practices. Introduction of clinical clerkships a number of years ago provided an opportunity for greater individualization of student experience during the third and fourth years. Instead of attending formal didactic lectures and demonstrations, the student was given the responsibility for a certain amount of patient care; thus, he might take the medical history, perform a physical examination, arrive at diagnostic considerations, perform indicated laboratory as well as other diagnostic and therapeutic procedures, and participate in the planning of therapy. The recent increase in the size of clerkship groups has tended, however, to compromise the benefits of this educational approach. Consequently, some alteration in the present conduct of clerkship teaching would appear indicated. We wish to report on two phases of the third-year pediatric clerkship program at the Yale University School of Medicine designed to meet some of the problems presented by large clerkship groups and to accomplish the purposes of medical education as we view them. These consist of the utilization of a tutorial system and the employment of personal interviews to discuss student performance.