Paediatric clinical exposure for medical students: Are they seeing enough?

Aim: To determine whether students are exposed to the 25 clinical presentations included in a comprehensive paediatric curriculum based on presenting features, as well as to evaluate for any variation in case exposure between the different locations and seasons of the student attachments. Methods: Students in the final 2 years of a 6-year medical degree completed logbooks during their 8-week paediatric attachment, recording which of 25 listed clinical presentations they had seen. Data were then collected regarding the period and location of the clinical placement, and which presentations had been seen by each student. Analysis was performed to detect differences in student case exposure depending on location and season of attachment, as well as the frequency with which each presentation was seen. Results: Three hundred and sixty-one student logbooks were included for analysis. Only one student had seen all 25 presentations; the median (range; interquartile range) number of cases seen was 14 (4-25; 11-17). There was no significant difference in the number of cases seen relating to location (rural, metropolitan or tertiary children's hospital) or season of the paediatric attachment. Only three presentations (infant/child with fever, breathing difficulties and vomiting/diarrhoea) had been seen by more than 90% of students; nine presentations had been seen by less than 50% of students. Conclusions: Students rarely gain exposure to all clinical presentations suggested in a comprehensive paediatric curriculum based on presenting features during an 8-week clinical attachment. Students have a similar experience regardless of the hospital or season of attachment.