The subinternship curriculum in internal medicine: A national survey of clerkship directors

Meenakshy K. Aiyer, Toan Vu, Cynthia Ledford, Melissa Fischer, Steven J. Durning

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Background: The 4th-year internal medicine subinternship (subI), with its strong emphasis on experience-based learning and increased patient responsibilities, is an important component of undergraduate medical education. Discussions have begun amongst educational leaders on the importance of standardizing curriculum and evaluation tools utilized during the subinternship. Purpose: The objective of this survey was to describe the current state of educational practices regarding the subI curriculum, use of Clerkship Directors in Internal Medicine (CDIM) curricular guidelines, evaluation methodologies, and subintern call frequency and duty hours. Methods: The survey was a part of the CDIM annual survey sent to 109 institutional members in 2005. The subinternship survey included 17 questions that addressed the prevalence of formal curricula in the subinternship, use of CDIM curricular guidelines and resources, and the evaluation tools utilized for assessment of the subinternship. Two questions examined the call frequency and duty hours of the subinterns. Results: Eighty-eight members responded (81%). Of the respondents, 37% have a formal curriculum and 35% used CDIM curricular guidelines for the subinternship. More than half of the respondents agreed that the curricular guide helped organize their subI rotations (53%), and 48% agreed that it enhanced the quality of subI education. A global rating summative evaluation form (56%) was the most commonly used evaluation tool in the subinternship. Objective Structured Clinical Examinations1-3 (1%) and Mini-Clinical Evaluation Exercise (mini-CEX)4(2%) were much less utilized during the subinternship. The respondents expressed an interest in the development of a standardized exam (47%) and clinical assessment tools such as the mini-CEX (59%). The vast majority of IM subinterns participate in 3 to 9 calls per rotation and spend less than 80 hr in the hospital per week. Conclusions: A formal curriculum is offered in slightly more than one third of subIs. Clerkship directors expressed interest in developing standardized evaluation tools to assess subintern competencies. The majority of IM subinterns spend less than 80 hr in the hospital per week. Further studies are needed to assess barriers to incorporating a formal curriculum and develop standardized tools to assess subintern competencies.

Original languageEnglish (US)
Pages (from-to)151-156
Number of pages6
JournalTeaching and Learning in Medicine
Volume20
Issue number2
DOIs
StatePublished - Apr 2008

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Internal Medicine
Curriculum
director
medicine
curriculum
evaluation
Guidelines
Undergraduate Medical Education
Surveys and Questionnaires
educational practice
education
rating
Learning
Exercise
leader
Education
responsibility
methodology
resources
learning

ASJC Scopus subject areas

  • Nursing(all)
  • Education

Cite this

The subinternship curriculum in internal medicine : A national survey of clerkship directors. / Aiyer, Meenakshy K.; Vu, Toan; Ledford, Cynthia; Fischer, Melissa; Durning, Steven J.

In: Teaching and Learning in Medicine, Vol. 20, No. 2, 04.2008, p. 151-156.

Research output: Contribution to journalArticle

Aiyer, Meenakshy K. ; Vu, Toan ; Ledford, Cynthia ; Fischer, Melissa ; Durning, Steven J. / The subinternship curriculum in internal medicine : A national survey of clerkship directors. In: Teaching and Learning in Medicine. 2008 ; Vol. 20, No. 2. pp. 151-156.
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abstract = "Background: The 4th-year internal medicine subinternship (subI), with its strong emphasis on experience-based learning and increased patient responsibilities, is an important component of undergraduate medical education. Discussions have begun amongst educational leaders on the importance of standardizing curriculum and evaluation tools utilized during the subinternship. Purpose: The objective of this survey was to describe the current state of educational practices regarding the subI curriculum, use of Clerkship Directors in Internal Medicine (CDIM) curricular guidelines, evaluation methodologies, and subintern call frequency and duty hours. Methods: The survey was a part of the CDIM annual survey sent to 109 institutional members in 2005. The subinternship survey included 17 questions that addressed the prevalence of formal curricula in the subinternship, use of CDIM curricular guidelines and resources, and the evaluation tools utilized for assessment of the subinternship. Two questions examined the call frequency and duty hours of the subinterns. Results: Eighty-eight members responded (81{\%}). Of the respondents, 37{\%} have a formal curriculum and 35{\%} used CDIM curricular guidelines for the subinternship. More than half of the respondents agreed that the curricular guide helped organize their subI rotations (53{\%}), and 48{\%} agreed that it enhanced the quality of subI education. A global rating summative evaluation form (56{\%}) was the most commonly used evaluation tool in the subinternship. Objective Structured Clinical Examinations1-3 (1{\%}) and Mini-Clinical Evaluation Exercise (mini-CEX)4(2{\%}) were much less utilized during the subinternship. The respondents expressed an interest in the development of a standardized exam (47{\%}) and clinical assessment tools such as the mini-CEX (59{\%}). The vast majority of IM subinterns participate in 3 to 9 calls per rotation and spend less than 80 hr in the hospital per week. Conclusions: A formal curriculum is offered in slightly more than one third of subIs. Clerkship directors expressed interest in developing standardized evaluation tools to assess subintern competencies. The majority of IM subinterns spend less than 80 hr in the hospital per week. Further studies are needed to assess barriers to incorporating a formal curriculum and develop standardized tools to assess subintern competencies.",
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