Effectiveness of standardized clerkship teaching across multiple sites

Surgical clerkship teaching for medical students at the University of Auckland is undertaken across multiple clinical campuses. Concerns are that differences in clinical experience may result in variability of learning outcome achievements. Our objectives were to investigate whether differences in clinical experience existed between teaching sites, and whether these differences correlate to differences in learning outcome achievements. Influence of clinical experience on future career choice was also explored.

Prospectively collected data were retrospectively reviewed. Clinical experience from assigned hospitals was collected using student Feedback Questionnaires and case history logbooks. Results were analyzed for inter-hospital differences. The Questionnaire included a question on influence of clinical experience on future career choice. A formative Objective Structured Clinical Examination (OSCE) was administered and results were analyzed for inter-hospital differences in learning outcome achievements.

Feedback Questionnaires and case history logbooks identified inter-hospital differences in clinical experience. Clerkship enjoyment and involvement in theater correlated with increased likelihood of choosing a future surgical career. The OSCE had acceptable internal reliability (Cronbach's α 0.69-0.74) and strong correlations with other formal assessments, indicating its external validity. No significant inter-hospital differences in OSCE results were found after one-way analysis of variance comparison (P=0.125).

Heterogeneity of clinical experience from multiple teaching sites did not translate into heterogeneity in achievement of learning outcomes when teaching and assessment materials were standardized. Clinical experience during undergraduate clerkships may influence future career choices. The OSCE is a validated and reliable tool for assessing student achievement of learning outcomes.