Impact of the site specialty of a continuity practice on students' clinical skills: performance with standardized patients.

Background: The assessment of clinical competence and the impact of training in ambulatory settings are two issues of importance in the evaluation of medical student performance.
Purpose: This study compares the clinical skills performance of students placed in three types of community preceptors' offices (pediatrics, medicine, family medicine) on yearly clinical skills assessments with standardized patients. Our goal was to see if the site specialty impacted on clinical performance.
Methods: The students in the study were completing a 3-year continuity preceptorship at a site representing one of the disciplines. Their performance on the four clinical skills assessments was compared.
Results: There was no significant difference in history taking, physical exam, communication, or clinical reasoning in any year (ANOVA p< or = .05) There was a small but significant difference in performance on a measure of interpersonal and interviewing skills during Years 1 and 2.
Conclusion: The site specialty of an early clinical experience does not have a significant impact on performance of most of the skills measured by the assessments.