STUDENTS EDUCATIONAL ACTIVITIES DURING CLERKSHIP

Purpose. To quantify the educational activities and types of teachers that medical students had in third-year clerkships at community-based teaching hospitals. Method. In October-November 1992, 201 students in third-year medical clerkships at nine community-based hospitals comple ted a log that recorded the primary activity, site, and educator and m ethod of education (for teaching or supervised activities) for each 15 -minute interval of a 24-hour day. Each hospital offered at least thre e of the clerkships studied: medicine, obstetrics-gynecology (ob-gyn), pediatrics, psychiatry, and surgery. Statistical comparisons of the c lerkships were done with chi-square analysis and one-way analysis of v ariance. Results. The students received 6.5 hours a day of teaching wi th an instructor and committed an additional 4.9 hours to clerkship-re lated learning. Nearly 75% of the teaching fell to full-time faculty m embers and residents. In just over half of their educational activitie s the students participated with other learners, such as residents. Th e clerkships did not differ significantly in the amounts of formal tea ching given; however, medicine did significantly more informal teachin g, and surgery and ob-gyn did significantly more supervised practice. Conclusion. This preliminary study quantified medical students' educat ional activities in 1992 during third-year clerkships and provides bas eline data describing these activities and the educators involved. Som e findings may not be replicable, however, with the increasing demands of full-time faculty members in inpatient and outpatient settings and the shifting emphases in how and where residents provide instruction. Another study such as this one would help assess the effects on medic al education of changes in the health care environment.