DOES VOLUME OF CLINICAL-EXPERIENCE AFFECT PERFORMANCE OF CLINICAL CLERKS ON SURGERY EXIT EXAMINATIONS

BACKGROUND: Controversy persists over the educational value of the vol ume of student clerkship clinical activities. METHODS: Students (109) from the class of 1995 recorded their clinical experiences in a logboo k during their surgical clerkship at one of four affiliated teaching h ospitals, The influence of clinical experience on examination scores a nd on correlations between prerotation and postrotation examination pe rformance was determined, RESULTS: Between sites, marked variation in clinical experience was observed but postrotation scores were similar. High-volume experience in emergency admissions and feedback was assoc iated with better objective structured clinical examination (OSCE) per formance, but high-volume outpatient clinic experience was associated with less satisfactory OSCE performance. Correlations between prerotat ion examination performance and the OSCE was increased by feedback on emergency and elective admissions, in a positive and negative directio n, respectively. CONCLUSIONS: These data show that surgical clerks' cl inical skills were enhanced by an increased volume of some but not all clinical experiences and that feedback does not necessarily enhance p erformance. These data suggest that both the volume of clinical experi ence and the quality of feedback should be carefully monitored by surg ical clerkship directors.