A multisite comparison of student activities in the surgery clerkship

The purpose of this study was to develop a method that would provide baseline data for the ongoing assessment of surgical clerkships at The University of Michigan Medical School. Of specific concern was the comparability of clerkship experiences among five different sites and the degree of variability in student experiences as the academic year progressed. Students (n = 168) in the required surgery clerkship at five affiliated sites completed a standardized daily log of the time spent on seven patient care activities and five formally structured educational activities for 1 week during each of five rotations. Analysis educational activities for 1 week during each five rotations. Analysis of variance and the Scheffe method for multiple comparisons were used to determine differences attributable to clerkship site and time of academic year. The results of the study revealed significant site-, rotation-, and activity-specific variations in the surgery clerkship experiences. However, the students at each of the five sites distributed their time almost equally between patient care and formal educational activities. The study has provided a model for assessing variability and change in the surgery clerkship program both within individual sites and across an entire affiliated hospital system. The instruments and methods are presented for adoption by other institutions with similar goals.