Relationship between clinical experiences and internal medicine clerkship performance.

Objectives: This study was conducted to assess the associations between several clerkship process measures and students' clinical and examination performance in an internal medicine clerkship.

Methods: We collected data from the internal medicine clerkship at one institution over a 3-year period (classes of 2010-2012; n = 507) and conducted correlation and multiple regression analyses. We examined the associations between clerkship process measures (student-reported number of patients evaluated, percentage of core problems encountered, total number of core problems encountered, total number of clinics attended) and four clerkship outcomes (clinical points [a weighted summation of a student's clinical grade recommendations], ambulatory clinical points [the out-patient portion of clinical points], examination points [a weighted summation of scores on three clerkship examinations], and National Board of Medical Examiners examination score).

Results: After controlling for pre-clerkship ability and gender, percentage of core problems was significantly associated with ambulatory clinical points (b = 3.84, total model R(2) = 0.14). Further, number of patients evaluated was significantly associated with clinical points (b = 0.19, total model R(2) = 0.22), but only for students who undertook first-quarter clerkships, who reported higher numbers of patients.

Conclusions: Notwithstanding a few positive (but small) associations, the results from this study suggest that clinical exposure is, at best, weakly associated with internal medicine clerkship performance.