Does the instructional quality of community-based clinical clerkships influence students' career preferences?

Masanobu Okayama and Eiji Kajii

Division of Community and Family Medicine, Centre for Community Medicine, Jichi Medical University, Japan

Submitted: 30/06/2011; Accepted: 16/08/2011; Published: 21/08/2011

Int J Med Educ. 2011; 2:74-79; doi: 10.5116/ijme.4e4a.d171

© 2011 Masanobu Okayama & Eiji Kajii. This is an Open Access article distributed under the terms of the Creative Commons Attribution License which permits unrestricted use of work provided the original work is properly cited. http://creativecommons.org/licenses/by/3.0

Objectives: The purpose of this study was to explore the association between student evaluation of their community-based clinical clerkship, their attitudes towards community health care and their career preferences.

Methods: Self-administered pre- and post-questionnaire surveys were given to 693 fifth-year medical students participating in a two-week community-based clinical clerkship. Items measured were student preference for a career in primary care, student evaluation of the pro-gramme and student attitudes towards community health care.

Results: Six hundred and forty-five students (93.1%), 494 (76.6%) male and 151 (23.4%) female, completed the pre- and post-questionnaires. Student preference for a career in primary care (75.4 ± 20.2) increased after the clinical clerkship. By multivariate analysis, it was found that evaluation of the programme ('The programme was a worthwhile learning experience.' [multivariate regression coefficient: 0.143, p=0.014]) and their attitude ('I think practising community health care is worthwhile.' [0.367, p<0.001]) were strongly associated with the increase in preference for a career as a primary care physician after the clinical clerkship.

Conclusions: Community-based education increases student preference for a future career as a primary care physician. Providing programmes of a high instructional quality further increases the chance of student physicians choosing a future career as a primary care physician.