A preliminary study of the effect of eliminating requirements on clinical performance.

This study determined the effect of a clinical program driven by patient needs upon students' productivity, attitudes, and academic performance. A group of eight senior students, whose academic and clinical performance profile replicated that of the rest of the class, were chosen to participate in a year-long non-requirement clinic. The students were expected to attend all clinic sessions, and treat their assigned patients. Their performance was compared to that of classmates in the regular requirement-driven curriculum. The non-requirement group had significantly higher academic achievement and significantly outproduced their classmates. Non-requirement students had no state board failures, versus 17 percent in the regular curriculum, and reported significantly lower stress. This study suggests that predoctoral clinical programs can maintain quality and productivity in the absence of unit requirements.