Enhancing Medical Student Education and Combating Mistreatment During a Surgery Clerkship With a Novel Educational Tool: A Pilot Study.

BACKGROUND

Medical education changes dramatically from preclinical to clinical years, and the learning environment becomes key as students strive to develop clinical competence and informed career decisions. This change becomes heightened on a surgical clerkship where student mistreatment is often perceived, and the fast-paced nature of surgery can result in limited resident-student interactions and time for examination preparation.

OBJECTIVE

To evaluate medical student and resident perception of educational strategies during a surgical clerkship and to determine whether the addition of a novel educational tool would increase satisfaction with the surgical clerkship on examination preparation and team dynamics.

SETTING

University of North Carolina at Chapel Hill, Department of Surgery.

STUDY DESIGN

During the 2018-2019 academic year, a 10-item "Ask a Resident Topics" (ART) card of high yield general surgery topics was implemented as part of the third-year surgery clerkship curriculum. Students were asked to review a topic and then discuss it with a general surgery resident. They were expected to complete at least 6 of 10 topics by the end of the rotation for credit. At the end of the year, third-year medical students were administered a 23-item survey regarding their experience on the surgery clerkship and with the ART cards. Fourth-year medical students and those students at satellite sites who did not receive the ART cards were administered the same survey, minus specific questions about the ART card, and were used as a preintervention control. General surgery residents who participated in teaching were similarly surveyed.

RESULTS

Of those students that completed the ART cards, 84% felt it improved their understanding of general surgery and were more likely to report the surgery clerkship prepared them well for the NBME examination compared to those who did not (Χ (1, N = 87) = 4.95, p = 0.03). They were also more likely to report residents were willing to discuss surgery topics with them (Χ (1, N = 87) = 2.77, p = 0.10). Seventy-three percent of students thought the card did not add undue stress to their clerkship. Sixty-three percent of all students felt they were a productive member of the surgery team, and this did not vary by intervention group (Χ (1, N = 87) = 0.03, p = 0.9). Students who completed the ART card were more likely to report being interested in surgery than those who did not (Χ (1, N = 87) = 4.20, p = 0.04). Hundred percent of residents surveyed felt the ART card provided value for themselves as a teacher and for the student as a learner.

CONCLUSIONS

The ART card is mutually beneficial to both residents and medical students during the surgical clerkship. This tool is easy to implement, helps students improve their understanding of general surgery, increases camaraderie among the surgical team, and has a positive impact on students pursuing a career in surgery.