Relevance of clerkship characteristics in changing students' interest in family medicine: a questionnaire survey

Objectives Exposure to family medicine (FM) can serve to promote students9 interest in this field. This study aimed at identifying clerkship characteristics which decrease or increase students9 interest in FM. Design This cross-sectional questionnaire study analysed students9 clerkship evaluations between the years 2004 and 2014. Descriptive statistics were used to compare four predefined groups: (1) high interest in FM before and after the clerkship (Remained high), (2) poor interest before and after the clerkship (Remained low), (3) poor interest before the clerkship which improved (Increased) and (4) high interest before the clerkship which decreased (Decreased). Setting Students9 evaluations of FM clerkships in the fourth of 6 years of medical school. Participants All questionnaires with complete answers on students9 interest in FM and its change as a result of the clerkship (2382 of 3963; 60.1%). The students9 mean age was 26 years (± 3.9), 62.7% (n=1505) were female. Outcome measure The outcome was a change in students9 interest in FM after completing the clerkship. Results Interest in FM after the clerkship was as follows: 40.1% (n=954) Remained high, 5.5% (n=134) Remained low, 42.1% (n=1002) Increased and 12.3% (n=292) Decreased. Students with decreased interest had performed a below-average number of learning activities (4 vs 6 activities). A total of 45.9% (n=134 of 292) of the students with decreased interest reported that the difficulty of the challenge was inadequate for their educational level: 81.3% (n=109) felt underchallenged and 18.7% (n=25) overchallenged. Conclusions In more than 50% of cases, the clerkship changed the students9 interest in FM. Those with decreased interest were more frequently underchallenged. We observed an increase in FM if at least six learning activities were trained. Our findings stress the importance of well-designed FM clerkships. There is a need for standardised educational strategies which enable teaching physicians to operationalise educational requirements.