What's Your Name Again? - Setting Expectations in the Surgical Clerkship

Malalignment in student versus service objectives may contribute to barriers in teaching and learning, occasionally resulting in conflict or perceived mistreatment. Expectation setting between the medical students and the residents at the start of each service during the surgery core clerkship was mandated and guided. This was done at 1 tertiary academic center.

One historic class did not undergo mandatory expectation setting and therefore were identified as the control group. The subsequent 2 class years were utilized as the intervention group. The 3 classes were surveyed, assessing markers representative of comfort, success, and confidence in the surgical clerkship. Responses were compared between control and intervention groups. Formal mistreatment reports were also utilized to examine if expectation setting and mistreatment discussions affected rates in these 3 years.

The overall response rate was 25%. Students who set expectations felt more comfortable asking questions in the operating room and advocating for themselves and their education during the clerkship. In the qualitative analysis, students most frequently credited the impact of expectation setting on their performance in the clerkship to increased direction, role clarity, and concrete goals for the clerkship. The number of mistreatment reports declined in the 2 years after expectation setting was initiated. Reports of rude or belittling language and public humiliation steadily declined.

Expectation setting at the beginning of the surgical core clerkship may enhance the students' sense of psychological safety to improve the learning environment for nontechnical skills development.