Garrard Comparison 1977

Garrard J, Verby JE Comparison of medical student experiences in rural and university settings Journal of Medical Education 52:802 1977

Patient encounter project of medical students, all encounters Nov 1974 - May 1975

RPAP students had 344 encounters per month, 3 times their home-based peers at 115 with differences in greater number and variety of skills encountered, higher level of responsibility for primary clinical problems (less responsibility compared to peers for clinical skills, also these were procedures with less apparent risk), greater continuity of care, more types of patients.

Both students perceived their actions to be educational vs service slightly over half of the time with not difference compared to each other.

Site of RPAP was 52% office. Site of controls 84 % hospital.

RPAP students saw proportionately more female patients and children (well baby) than controls.

RPAP students saw more new clinical problems 49 vs 45% and referred less.

Confidence ratings on 54 medical-biological and psychosocial skills with 5 point Likerd, before and just after, on 38 students and 49 controls. On pretest in 67% there was equivalence and the RPAP group had less perceived confidence in the remaining third. At post test this was reversed. There was a higher increase in confidence in 67% of RPAP students. The RPAP group had no skills where they perceived less confidence. No difference in board score changes, except public health

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