1. The Role of Third Year Medical Students and the Potential for Change
2017 AAMC WGEA Regional Meeting
Catherine Burke MS4
Dylan Masters MD
Patricia O’Sullivan EdD
Leslie Sheu MD
UCSF School of Medicine
2/26/17
6/11/2018
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2. Background
Abraham Flexner
William Osler
The organization of modern medical school has historical roots
Curricular changes largely occur within this preexisting structure
Need to better understand the current role of third year students in order to design effective pre-clinical curricular changes
The Role of Third Year Clerkship Students and the Potential for Change
2/26/17
6/11/2018
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3. Research Questions What is the role of the third year medical student?
What are the factors that influence this role?
What is the potential for the role to change, especially in the context of curricular change?
The Role of Third Year Clerkship Students and the Potential for Change
2/26/17
6/11/2018
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4. Study Methodology
Qualitative research study analyzing 22 semi-structured interviews with clerkship and site directors
Open-coding of transcripts using thematic analysis
Construct conceptual model for understanding the MS3 role
The Role of Third Year Clerkship Students and the Potential for Change
2/26/17
6/11/2018
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5. Results - Overview Factors influencing the third year role: Student
Supervisor Factors
Systems
Factors
Three archetypes of the third year student:
The Apprentice
The Intellectual
The Communicator
The Role of Third Year Clerkship Students and the Potential for Change
2/26/17
6/11/2018
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6. Results – Factors Influencing the Role
Student
Factors
“So generally, ones who are a little bit more outgoing, take more initiative - those are the ones who generally have the more favorable experience.”
Supervisor Factors
“I meet with the students before they start their rotation and I go through expectations, but it is very much team-driven and team-dependent … I just don't know that everybody utilizes the medical students in the same way.”
Systems
Factors
“When the residents are out on vacation or in clinic we do tend to tell the students, ‘We'd like you to do a little bit more.’ We do that but not without support, and not without some feedback also.”
The Role of Third Year Clerkship Students and the Potential for Change
2/26/17
6/11/2018
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7. Results – Three Student Archetypes
The Apprentice
“The current role of a MS3 is to be a novice physician. Their role is to take care of patients under close supervision by a resident and intern, [and] to act as one of the primary care givers of a patient. It is very much an apprenticeship model.”
The Intellectual
“The students who stand out are the ones who are able to collate all those tests in a nice spreadsheet, know what each of them is being sent for, and what the test characteristics of each one of those tests are, […] then go to literature and pull papers that help us understand.”
The Communicator
“I love it when students are there with the family […] I've heard from many families and patients that they really benefited from having a student there, as far as being their proponent in their patient centered experience and relaying that to the team.”
The Role of Third Year Clerkship Students and the Potential for Change
2/26/17
6/11/2018
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8. Discussion - Implications
Curriculum Design
Utility of pre-clinical curricular changes for third year medical students may vary depending on archetype balance
Evaluation
Deviation from expected archetype may lead to inappropriate grading practices
Cultural Consensus
Preparing students for clinical rotations
Providing shared vocabulary for students and supervisors to describe expectations and roles during rotations
The Role of Third Year Clerkship Students and the Potential for Change
2/26/17
6/11/2018
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9. Conclusion Future Directions
The third year role is determined by intrinsic student factors, supervisor-specific factors, and systems factors
There are three distinct third year medical student archetypes: the apprentice, the intellectual, and the communicator
The balance of the archetypes depends on the actors involved and their shared environment
Integrating the perspective of third year students into framework
Reassessing the way students are oriented and evaluated
Incorporating framework into faculty training and development efforts
Future Directions
The Role of Third Year Clerkship Students and the Potential for Change
2/26/17
6/11/2018
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10. Acknowledgements Special thanks to:
- Dr. Leslie Sheu, Dr. Patricia O’Sullivan, and Dr. Dylan Masters
- UCSF School of Medicine
- UCSF Health Professions Education Pathway
- AAMC WGEA
The Role of Third Year Clerkship Students and the Potential for Change
2/26/17
6/11/2018
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11. Parnassus Aerial by Hawkeye Photography
6/11/2018
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