Alternating skills training and clerkships to ease the transition from preclinical to clinical training

Figures & data

Table

Practice points

In a dual learning year, periods of just-in-time skills training in an educational environment and periods of clerkships in a workplace environment alternate. In a curriculum where all skills training is provided prior to the clerkships, students experience more transition difficulties concerning high workload than in case of a dual learning year. The dual learning year decreases the workload students experience, while this is not at the cost of students’ perceptions of their level of skills. Alternating skills training and clerkships may ease the transition from preclinical to clinical training.

Figure 1. Overview of curricula and measurement moments.

Table 1.  Four junior rotations and the corresponding medical specialties

A	B	C	D
Rehabilitation	Internal medicine	Surgery	Obstetrics/
Orthopaedics	Pulmonary	Ear, nose and throat	Gynaecology
Rheumatology	Endocrinology	Oncology	Paediatrics
Neurology	Cardiology		Urology
Psychiatry	Dermatology
Ophthalmology

Figure 2. Mean scores for experienced workload. Dual learning year, divided into mini-transitions and baseline measurement.

Table 2.  Mean scores and standard deviations experienced workload (1 = low workload and 5 = high workload), perceived skills level (1 = low skills level and 5 = high skills level) and GHQ-12 score

	1st junior rotation	2nd junior rotation	3rd junior rotation	4th junior rotation	1st senior clerkship	F/χ^2
Experienced workload
Mean (SD)	2.97 (0.66)	2.74 (0.66)	2.78 (0.81)	2.69 (0.74)	2.65 (0.76)	3.515*
Perceived skills level
Mean (SD)	3.39 (0.40)	3.60 (0.42)	3.73 (0.42)	3.88 (0.37)	3.86 (0.38)	28.701**
GHQ-12
Mean (SD)	2.25 (2.36)	1.73 (1.92)	2.47 (2.62)	1.96 (2.80)	1.45 (2.20)	2.471***
% cases	23.3	15.1	25.7	20.0	13.8	5.757

Notes: SD = standard deviation.

*p < 0.01; **p < 0.001; and ***p < 0.05.

Figure 3. Mean scores for perceived skills level. Dual learning year, divided into mini-transitions and baseline measurement.

Figure 4. Mean score for GHQ-12. Dual learning year divided into mini-transitions.