DOES VOLUME OF PATIENTS SEEN IN AN OUTPATIENT SETTING IMPACT TEST-SCORES

BACKGROUND: Methods of teaching surgery in the outpatient setting and means to measure the effectiveness of these methods have not been defi ned. This study was designed to evaluate the impact of number of outpa tient encounters on test scores for third-year medical students. METHO DS: Students rotating on the required third-year surgery clerkship bet ween July 1994 and June 1996 kept a log of their activities including number of patients seen in clinic, number of cases scrubbed, and pages read. At the end of the rotation the students were given an essay exa mination and a multiple-choice examination. The data were analyzed loo king for correlation between examination scores and volume of patients seen. United States Medical Licensing Examination (USMLE) Step 1 scor es were used as a baseline measure to compare the rotation groups. RES ULTS: USMLE scores did not differ between groups. Mean essay examinati on scores varied significantly between some rotation groups, but did n ot follow a pattern. There was no correlation between the number of pa tients seen in clinic and essay examination scores. There was a signif icant correlation between essay score and USMLE Step 1 score (Pearson' s r = 0.398) and between essay and multiple-choice examination scores (Pearson's r = 0.313). There was a significant negative correlation be tween number of patients seen in clinic and number of cases scrubbed ( Pearson's r = -0.347). CONCLUSIONS: Participation in outpatient surger y clinics did not result in improved performance on written examinatio ns in this surgery clerkship. To achieve the most benefit from the out patient clinic, objectives of the experience need to be determined and appropriate tools used to measure their successful achievement. (C) 1 998 by Excerpta Medica, Inc.