What do students actually do on an internal medicine clerkship? A log diary study

Area of Science:

• Medical Education
• Internal Medicine Clerkship
• Student Learning Activities

Background:

• Limited data exists on medical student time allocation during internal medicine clerkships.
• International variation in teaching time is significant.
• Community-based internal medicine teaching is increasing, but its effectiveness relative to hospital-based teaching is unclear.

Purpose of the Study:

• To quantify time medical students spend on various activities during internal medicine clerkships.
• To compare time allocation between general practice and hospital-based settings.
• To assess student perceptions of the educational value and enjoyment of different learning activities.

Main Methods:

• Prospective study involving medical students completing log diaries.
• Students recorded activities over two weeks: one in general practice, one in hospital.
• Data collected on time spent and perceptions of educational value and enjoyment.

Main Results:

• Students spent approximately 5.5 hours daily on teaching and learning in both settings.
• More time was spent on unsupervised patient interaction in hospitals (50 min vs. 30 min).
• More time was spent on assessment in general practice (53 min vs. 21 min).
• Students rated supervised patient interaction and doctor-led teaching as most educational.
• General practice settings were perceived as more educationally valuable and enjoyable for patient interactions.

Conclusions:

• Patient interactions are highly valued by students for both educational content and enjoyment.
• Patient-based learning should remain central to undergraduate medical education.
• Significant heterogeneity in student experiences suggests a need for personalized learning approaches despite standardized timetables.