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Team-based versus preceptor-based assignment of junior surgery students

K S Ephgrave1, K Ferguson, C Kreiter

  • 1Department of Surgery, University of Iowa, College of Medicine, and Veterans Affairs Medical Center, Iowa City, USA.

American Journal of Surgery
|April 1, 1997
PubMed
Summary
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Assigning junior surgery students to individual faculty preceptors improved evaluations and honors recommendations but did not affect exam performance. This new format offers benefits but also drawbacks for student learning.

Area of Science:

  • Medical Education
  • Surgical Training
  • Clinical Evaluation

Background:

  • Junior surgery student evaluations often lack detailed feedback.
  • Large general surgery teams may reduce personal accountability.
  • Current evaluation methods may not support effective student learning.

Purpose of the Study:

  • To investigate the impact of assigning students to individual faculty preceptors versus teams on clinical evaluation quality.
  • To determine if a preceptor model enhances student accountability and feedback.
  • To assess the effect of different assignment formats on student performance and satisfaction.

Main Methods:

  • A 1-year study involving 154 junior medical students in 8 clerkships.
  • Students were alternately assigned to a Team format (3-5 students) or a Preceptor format (1-2 students per faculty).

Related Experiment Videos

  • Approximately one-third of Preceptor students were assigned to subspecialists to maintain a low student-to-faculty ratio.

    • Main Results:

    • The Preceptor format led to more descriptive evaluations (3.2 adjectives vs. 2.5) and higher Honors recommendations (47% vs. 25%).
    • No significant impact was observed on exam performance, student perceptions of faculty, or self-reported clinical activity.
    • Team format students reported fewer patients; Preceptor students reported less than "good" informal instruction.

    Conclusions:

    • Preceptor assignment improved evaluation descriptors and Honors recommendations but not exam scores.
    • Both formats presented distinct advantages and disadvantages for students.
    • Recommendations include limiting team sizes and incorporating structured formative feedback to optimize the learning experience.