Outcomes analysis of teaching on a medical service with trainees of diverse medical experience

Rotations in medical subspecialties often involve trainees with diverse levels of medical knowledge and experience. We conducted a study to determine whether teaching on such a clinical service could be delivered effectively to all members of the group despite their disparate backgrounds.

The Section of Endocrinology offers a 4-week rotation that is taken jointly by third- and fourth-year medical students, interns, residents and endocrinology fellows. Over the past 4 years enrollees were required to complete both a pre and postcourse test of written, multiple choice examination in general endocrinology. The mean and SEM percentage of correct answers were compared.

It was found that the scores on the prerotation test were correlated with the level of experience; students scored the lowest and fellows the highest. There was a significant overlap; however, between groups, students' results, for example, were not statistically different from those of the interns but were lower than those of the residents and very different from fellows (p value < 0.0001).

Rotations of trainees with mixed ability clearly lead to objective improvements in all groups except fellows. Students and interns appear to gain the greatest increment. Residents also improve. It is concluded that all levels of trainees (below the level of fellow) can increase their fund of knowledge by taking a subspeciality rotation even though the group may be of mixed levels of ability.