부산대학교 도서관

Purpose: Numerous components contribute to varied experiences among medical students on surgical clerkships. A welcoming environment, involvement in procedures, and educational opportunities confer a positive experience, which in turn influences specialty selection. Unfortunately, findings from recent studies ranking the clinical learning environment during general surgery have been quite limited. A better understanding of the etiology of these rankings is needed. The purpose of this study was to perform a multi-institutional assessment of the learning environment during the general surgery clerkship and identify differences amongst medical student (MS), resident, and faculty perceptions of this environment.Methods: Anonymous electronic surveys were sent to MS upon completion of their surgical clerkship, in addition to surgical residents and faculty at four institutions over a 6-month period. Survey responses were compiled and analyzed using Kruskal–Wallis ANOVA with p < 0.05 considered significant.Results: Responses were obtained from 144 MS (43% response rate), 64 residents (28% response rate), and 99 faculty (26% response rate). MS and residents reported similar perceptions of weekly hours of instruction received and desired, which were slightly higher than those reported by faculty (p < 0.001). MS were more satisfied with the quality and amount of clerkship teaching (p = 0.04, p = 0.012) compared to residents and faculty. Notably, 20% of MS felt their teaching was “mostly an inconvenience” for residents and faculty while residents and faculty shared this sentiment only 2–6% of the time (p < 0.0001). In fact, most residents (57%) and faculty (48%) viewed teaching MS as an asset (p < 0.0001). Additionally, most medical students felt they were wanted on the surgical team less than half of the time, with 15% feeling they were welcome none of the time, while a majority of residents (79%) and faculty (69%) wanted MS on their team most or all the time (p < 0.0001).Conclusions: These data highlight ongoing discrepancies in the surgical clerkship learning environment as experienced by MS, residents, and faculty. Our data demonstrate alignment of MS, resident, and faculty expectations related to MS satisfaction with the amount and quality of teaching received during their surgical clerkship. However, striking differences remain in MS perception of the inconvenience of their clerkship learning and their lack of inclusion on the surgical team. Further research and interventions to bridge this divide are paramount.