Offered the opportunity to take the previous quarter's post-test as a pre-test at the beginning of their 3-month medicine clerkship with the understanding it would have no effect on their final grades, 132 of 148 students (89%) took this opportunity. Post-test means for each quarter's group were significantly greater than pre-test means (P=0.0001). Pre-test means did not increase over the four quarters of the year of this study despite increasing student experience in other clinical disciplines. For this entire year correlations were as follows: Pre-test vs post-test r=0.591 (P=0.0001), pre-test vs clinical r=0.306 (P=0.0004), and post-test vs clinical r=0.329 (P=0.0001). By quarter these correlations were generally consistent. An interesting and unexpected finding was that students in the autumn quarter had significantly lower pre-test and clinical scores than students in the winter quarter. This may indicate that students highly motivated to medicine take this as their first clinical clerkship and those least motivated as their last first clinical-year clerkship.
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