Development of competence in clerkship.

Students' perceptions of their educational experience on Surgery and Medicine rotations of a clerkship program were analysed. Six components of the education process, namely (1) frequency of individual teaching, (2) quality of contact with staff-clinicians, (3) appropriateness of responsibility for patient care, (4) appropriateness of supervision received, (5) frequency of admissions reviewed and (6) frequency of opportunity to follow-up patients admitted, were correlated with students' confidence in their ability to function competently. Mean scores of clerks' confidence in their competence was the same for both rotations. Breakdown by sex revealed females to feel more competent on medicine, and males on surgery. On the medicine rotation a moderate relationship was found between two of the components tested and the dependent variable; on surgery, strong correlations were found between four of the components tested and the dependent variable. Regression analysis demonstrated appropriateness of responsibility for patient care to have a low predictor value for achievement of competence on medicine, while quality of contact with staff-clinician and appropriateness of supervision received were strong predictors of achievement of competence on the surgery rotation.