Orientation to Social Medicine and the Bronx: An Educational Experience for Adult Learners

Background: Little attention has been paid to the orientation process used to assist residents in their transition from student to physician. Description: The Residency Program in Social Medicine of the Montefiore Medical Center/Albert Einstein College of Medicine developed an innovative orientation for 1st-year residents in primary care internal medicine, pediatrics, and family practice, built on the principles of adult education. Evaluation: Formative evaluation questionnaires from four orientation cohorts, 1990-93, were analyzed (total residents = 77, respondents = 66, response rate = 86%), including both quantitative (Likert scale) and qualitative assessments of its goals and learning activities. Over the 4 years analyzed, 95% of the residents' median evaluation met or exceeded their expectations. More than 60% of the residents' median evaluations of all learning activities were rated very good to excellent. Qualitative evaluations highlighted both the special virtues and drawbacks of such an adult learning experience. Conclusions: This orientation conforms to the principles of adult education and has consistently achieved its goals in orienting residents to the history, organization, and culture of their clinical institutions and community.