Logbooks in clinical use-is there a benefit for the students ? An Evaluation among final-year-students in internal medicine

Main emphasis in terms of clinical practice is put on final year medical education at German universities. Portfolios or logbooks are often used to ensure standards and a structured training. However, only few studies are available that investigated the personal benefit of a logbook for the students. To validate the logbooks’ acceptance, its integrative function and impact on quality of final year students’ medical education, we designed and evaluated a task-based logbook for Internal Medicine at the Heidelberg University Hospital. By longitudinal analysis of two cohorts (before and after logbook introduction), we were able to show that after logbook introduction, students felt more integrated in ward routine and considered the dedicated training periods by ward doctors to be more sufficient. Furthermore, students stated to have performed more ward rounds and to have written more discharge letters. General satisfaction with their clerkship also increased significantly. However, an additional survey after this training period showed that many of the obligatory clinical tasks were not performed as documented in the logbooks. We conclude that a task-based logbook is an appropriate tool to enhance communication between students and doctors on ward, facilitating integration on ward by giving the students the chance to claim teaching actively. Although the documentation of clinical tasks in the logbook hasn’t proved to be really effective, we consider this tool as an useful structuring element that enhances students’ satisfaction in practical medical training.