Learning activities and high-quality teaching: perceptions of third-year IM clerkship students

To identify learning activities that students associate with high-quality teaching on a clinical rotation.

From July to December 2001, data on patient encounters, learning activities, and teaching quality were collected via personal hand-held computers from 82 medical students during a required third-year internal medicine (IM) clerkship at the Medical College of Wisconsin, Milwaukee. Univariate (chi-square test) and multivariate analysis (stepwise multiple logistic regression) were performed to assess the association between learning activities and students' perceptions of teaching quality during this rotation.

A total of 1,839 patient encounters were recorded: 62% of these occurred in the inpatient setting and 38% in outpatient clinics. In 80% of all encounters, students reported that they gave an oral case presentation and proposed a plan; they reported receiving high-quality feedback after 64% of these presentations. Univariate analysis demonstrated that the students' perception of high-quality teaching was associated with being on an inpatient rotation, formulating an assessment, proposing a plan, presenting to the attending physician with other members of the team present, giving an oral case presentation, and receiving high-quality feedback (p <.01). Multivariate analysis demonstrated that receiving high-quality feedback (odds ratio [OR] 4.5; 95% CI 3.57-6.25) and proposing a plan (OR 2.3; 95% CI 1.4-3.9) were the two strongest predictors of high, overall teaching quality.

Receiving high-quality feedback from faculty and proposing a plan were the learning activities most strongly associated with students' perception of high-quality teaching on a required third-year IM clerkship.