Academic medicine : journal of the Association of American Medical Colleges
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To identify previously unrecognized factors influencing medical students' career choices and to better characterize the effects of educational experiences, role models, and educational debt on career decisions. ⋯ Students' career decisions are complex, dynamic, and individualized processes. The use of qualitative measures helps bolster understanding of these processes by identifying new factors (such as mastery of knowledge) and by further characterizing known factors (such as role models and financial considerations). A comprehensive and valid understanding of students' career-decision making is necessary to develop successful strategies to sustain and encourage the choice of primary care careers.
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The authors explored the extent to which medical schools have established institutional and departmentalized educational objectives, by examining the accreditation databases, institutional self-studies, and site visit reports of 59 schools surveyed by the Liaison Committee on medical Education (LCME) in 1994-1996. In this study, the individual school was the unit of analysis, and the dependent variables were statements--in outcomes' terms--of institutional and departmental learning objectives. Objectives were classified as "robust" when they were expressed as measurable learning outcomes in the domains of knowledge and skills and behaviors. ⋯ Schools that paid attention to the explication of learning objectives were more likely to link specific institutional and departmentalized outcomes with methods of evaluating students, in turn guiding the content and methods of instruction. Schools with vapid objectives attracted 40% more accreditation citations for shortcomings in curricular management, course and clerkship quality, and the evaluation of student achievement, especially in the clinical skills domain. In the future, accreditors should focus more closely on this association.