The Effects of First Year Medical Students’ Gender and Career Interest on Educational Gains from Longitudinal Cases

There is little research to date regarding the effectiveness of longitudinal case-based assignments in the education of first year medical students. Such assignments were recently added to the curriculum of the Anatomy and Pathology courses at Mayo Medical School in order to increase students’ understanding of the clinical relevance of information they learned in didactics. This study was designed to assess whether certain subpopulations of students achieved greater benefit from the use of these assignments. Longitudinal cases that focused on clinical aspects of disease (patient presentation, assessment, differential diagnosis, treatment options, and psychosocial issues) were assigned weekly during Anatomy and Pathology. Following these courses, students were surveyed regarding perceived benefit of the assignments in helping them to understand the didactic information they were learning from a clinical perspective. Survey responses and student assignment grades were analyzed based on groupings by career interest and gender. Survey response differences were striking when grouped by general career interests. Students undecided about their future career interests perceived significantly less benefit from the longitudinal assignments than their peers who were interested in a particular field of medicine in terms of gathering clinical information, developing diagnoses and treatment plans, integrating didactic information with clinical knowledge, and overall value of the assignments. Students with no specific career interest also had significantly lower assignment grades than those who had a specific field of interest. Survey responses did not differ significantly across gender. Comparison of students’ grades when grouped by gender demonstrated a trend toward significance, with females outperforming males on these assignments. In summary, students with no specified career preference perceived markedly less benefit and performed poorer on longitudinal case-based assignments than students with a specified career interest, while gender differences displayed no significant associations.