The third-year medical student "grapevine": managing transitions between third-year clerkships using peer-to-peer handoffs.

PURPOSE: As third-year medical students rotate between clerkships, they experience multiple transitions across workplace cultures and shifting learning expectations. The authors explored clerkship transitions from the students' perspective by examining the advice they passed on to their peers in preparation for new clerkships.
METHOD: Seventy-one students from three Veterans Affairs-based clerkship rotations at the University of California, San Francisco, School of Medicine participated in a peer-to-peer handoff session from 2008 to 2011. In the handoff session, they gave tips for optimizing performance to students starting the clerkship they had just completed. The authors transcribed student comments from four handoff sessions and used qualitative content analysis to identify and compare advice across clerkships.
RESULTS: Students shared advice about workplace culture, content learning, logistics, and work-life balance. Common themes included expectations of the rotation, workplace norms, specific tasks, learning opportunities, and learning strategies. Comments about patient care and work-life balance were rare. Students emphasized different themes for each clerkship; for example, for some clerkships, students commented heavily on tasks and content learning, while in another students focused on workplace culture and exam preparation.
CONCLUSIONS: These findings characterize the transitions that third-year students undergo as they rotate into new clinical training environments. Students emphasized different aspects of each clerkship in the advice they passed to their peers, and their comments often describe informal norms or opportunities that official clerkship orientations may not address. Peer-to-peer handoffs may help ease transitions between clerkships with dissimilar cultures and expectations.