A model for tracking student experiences on surgical clerkships

This study was conducted to identify the range and nature of surgical clerkship experiences in three different hospital settings-university, community, and public.

An instrument was developed to track the location and type of learning experience, patient demographics, surgical content, and clinical experience of students on their surgical clerkship. Twenty-three students used the instrument to record the events of their surgical clerkship. Data were analyzed to describe the frequency of tasks performed, the nature and location of learning experience, exposure to surgical topics, and patient demographics.

Students were involved in an average of 245 common surgical tasks over their 8-week clerkship. Of their exposure to common tasks, students had the opportunity to observe 25% and perform 70% of those tasks. Sixty-six percent of task work occurred on the patient floor and 23% occurred in the operating room. Students were exposed to a broad range of surgical topics, 71% of which were general surgery topics. Only 25% of these experiences were auditory, whereas 39% involved exposure to a patient, and 36% included participation in an operation. Patient load and characteristics tended to vary across hospital settings, and on average, students worked with 164 patients during their clerkship. The smallest patient load (m = 113) occurred in the university hospital and the largest patient load (m = 251) occurred in the public hospital.

Although surgical services and hospital settings may offer students different clerkship experiences, the common clinical and didactic components of a surgical clerkship can balance a student's exposure to surgical topics and practice of clinical skills. Tracking surgical clerkship experiences is valuable in identifying the range and nature of medical students' didactic, clinical, and operative experiences.