Clerkship encounter forms were used to assess the types of diagnoses seen, the level of activities performed (student responsibility), and self-reported competence (comfort level) in dealing with patients.
Introduction: Many medical schools require a family medicine clerkship, yet little is known about the quantity and diversity of the diagnoses encountered by the students. This study examines clerkship students' experience with women's health care diagnoses.
Methods: Over a 2-year period, 445 students completed 3320 patient encounter forms for patients with a women's health diagnosis, noting patient age, location of care (office, hospital, etc.), up to four presenting diagnoses, the degree to which the student was involved with selected activities (taking a history, performing a physical examination, observing only, etc.) and the degree of self-reported competence.
Results: Of the 78 854 diagnoses presented, 3677 (6.1%) were women's health conditions, most commonly normal pregnancy (47.5%), disorders of menstruation (8.2%), menopausal and postmenopausal disorders (7.4%), disorders of the breast (6.0%), pain in female genital organs (5.7%), and disease of the cervix, vagina and vulva (5.2%). Students reported a high level of competence in diagnosing and treating these patients. The students routinely discussed women's health cases with their preceptors.
Discussion: Students reported that they were 'unskilled' or 'marginally competent' with approximately 10% of the women's health patient encounters, compared with 6% for all other encounters. The clerkship provided students with the greatest opportunity to observe and discuss individual cases with a preceptor. However, students infrequently suggested a treatment or provided patient education or women's health counselling.