Does the outpatient setting provide the best environment for medical student learning of urology?

To determine in which environment medical students learn clinical urology most effectively, we retrospectively reviewed a natural experiment in which medical students were randomly assigned to complete the 1-week rotation in clinical urology in an outpatient/clinic based or inpatient/operative setting.

Exit surveys were completed by 25 of the 39 medical students (64%) who had just completed the mandatory 1-week rotation in urology. Students were asked to record on a 5-point scale the amount learned in regard to 13 urological topics and skills, and to document the number of patient encounters experienced per topic and skill.

Students randomized to the outpatient/clinic based setting tended to be 1) more likely to have exposure to a greater number and breadth of patients with common urological problems, 2) more likely to perform pertinent physical examination skills and 3) more likely to perceive that they learned more about a given curricular topic or skill.

Our data indicate that the outpatient/clinic based setting may be a higher yield environment for medical students learning clinical urology compared with the inpatient/operative setting. The development of a validated means to assess actual student learning in clinical urology is needed to confirm these findings.