What clinical rotation factors have an impact on trainee success?

Educators and trainees both recognise that autonomy, the number of patient encounters and setting learning outcomes are all vital for a successful residency. This study examined whether these clinical rotation characteristics have an impact on trainee success in an orthotic and prosthetic clinical residency.

Two cohorts of resident trainees rated their rotation characteristics (autonomy, patient encounters and learning outcomes [1, significantly below expectations; 5, exceeds expectations]) and self-competency (77 items [1, not at all able; 5, very able]) at three points during an 18-month residency. Rotation performance (0-100, where 100 is the highest score) was ascertained with preceptor ratings and test scores. Means and correlations were derived.

Data from 38 trainees were examined. The mean self-competency and rotation performance scores improved from time 1 to time 3 (from 4.14 ± 0.43 to 4.36 ± 0.38 [p < 0.01]; from 90.74 ± 5.15 to 92.62 ± 4.55 [p < 0.05]). Autonomy correlated with performance at time 1 (p < 0.05) only, and did not relate to self-competency at any point. Neither the number of patient encounters nor the presence of learning outcomes were associated with performance or self-competency at any point.

These data show that over time our trainees become more competent, as rated by both themselves and their preceptors. These data do not suggest that the number of patient encounters and the presence of learning outcomes have an impact on trainee competence. Autonomy may play the largest role at the beginning of the residency as students make the transition to clinical practice.