Student assessment of clinical experience in general surgery.

Forty-two students kept a log diary of all activities during their general surgical firms at a main university hospital in London. The students saw on average 35 patients per week on whom physical aspects were discussed by the consultant with the student after the consultation in 58%, psychological aspects in 4% and social aspects in 1.6%. Students spent an average of 11.2 hours per week with patients. In outpatients students spent most of their time as passive observers, but there were opportunities for more active involvement on the wards. Here the students spent on average 1.5 hours per week personally examining patients and 1 hour per week taking histories. Each student performed on average two short and one long examination per week and 0.5 short and 2.25 long histories per week. The students received on average 2.9 hours per week of consultant teaching in small groups, junior medical staff teaching at 2.2 hours and non-medical staff teaching of 1.1 hour per week. Students spent almost 4 hours per week attending formal traditional lectures in large groups. Some areas identified for improvement were: the relatively little feedback and supervision students received when personally examining patients and taking histories; the passive involvement of students in most educational settings; the small amount of time devoted to discussing social and psychologically relevant factors in the history; the few practical procedures personally performed by students; the relatively large amount of time students reported as unproductive and the small amount of time spent on self-education.(ABSTRACT TRUNCATED AT 250 WORDS)