Teaching newborn medicine to third-year medical students. Use of a checklist

F. A. McCurdy and L. E. Weisman
Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, Md.

OBJECTIVE: To determine if use of a checklist during the third-year medical student's newborn medicine rotation within the pediatric clerkship affected grades, end-of-course examination scores, or perceptions of the new-born clinical experience before and after use of this teaching aid. METHODS: The checklist contained 46 newborn medicine-related skills and concepts and required staff review. A postclerkship questionnaire was used to assess the student's perception of all components of the clinical clerkship. A standardized test was used to assess clinical knowledge. The clerkship grade was based on test scores (30%) and clinical performance (70%). RESULTS: All students (N = 321) returned the postclerkship questionnaire from July 1, 1988, to June 30, 1990, and the checklist plus questionnaire (N = 294) from July 1, 1990, to June 30, 1992. During both periods, the curriculum and clinical experience remained unchanged. Although there was no change in grade distribution, mean final examination score (P < .011) and student perception of the nursery portion of the clerkship (P < .01) improved significantly after we began using the checklist. "Poor" ratings of the nursey experience decreased from 12% (1988 to 1989) to 3% (1991 to 1992), and "excellent" ratings increased from 13% to 24%. In addition, examination performance on specific examination questions appeared related to completion of checklist items (r = .68, P < .016). CONCLUSIONS: Use of a readily available checklist, to remind students and faculty of the skills and concepts to be mastered during the nursey portion of the clerkship, did not impact final grades, although information transfer and student perception of the clinical experience improved. We speculate that clear delineation of readily available objectives focuses students and staff, decreases anxiety, and provides a sense of accomplishment.