Dual Learning in an Emergency Medicine Clerkship Improves Student Performance

BackgroundThe emergency department (ED) is an ideal environment to teach learners about the "undifferentiated patient." Student learning may be inconsistent because of inherent variability in the ED. Previous research has suggested that standardizing the emergency medicine (EM) clerkship by implementing didactics and requiring students to see patients with particular chief complaints improves educational outcomes.ObjectiveTo compare knowledge acquisition after a new curriculum to the traditional curriculum.MethodsThis was a prospective, quasiexperimental study of senior medical students in an EM clerkship. Students were assigned to the dual learning (DL) group or standard learning (SL) groups based on month of rotation. All were required to see patients with 10 specific chief complaints and were lent an EM textbook. The SL group was instructed to read about the required cases. The DL group attended a 2-hour didactic session covering 5 of the 10 required cases. All students completed an identical pre- and postclerkship multiple choice knowledge test.ResultsData from 51 medical students (DL = 27; SL = 24) were analyzed. Mean pretest scores were comparable between groups. A 2 (groups) by 2 (sessions) mixed-design analysis of variance yielded a significant group by session interaction effect (p < 0.001). The DL group significantly increased its mean score from 8.7 (standard deviation [SD] = 1.8) pretest to 11.6 (SD = 1.9) posttest; there was no improvement in the SL group (pretest: 9.3 [SD = 1.5], posttest: 10.0 [SD = 2.0]).ConclusionA DL model combining clinical and enhanced didactic requirements for an EM clerkship led to greater knowledge gain than the standard curriculum. This model may suggest ways to improve the educational experience in the EM clerkship