Surgery clerkship offers greater entrustment of medical students with supervised procedures than other clerkships
Medical student procedural participation is increasingly limited, creating concerns over poor preparation for internship. Inadequate experiences may also compromise patient safety. This study explores variances in procedural entrustment of medical students between core clerkships during the first cl...
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| Veröffentlicht in: | The American journal of surgery 2020-09, Vol.220 (3), p.537-542 |
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| creator | Foote, Darci C. Reddy, Rishindra M. Matusko, Niki Sandhu, Gurjit |
| description | Medical student procedural participation is increasingly limited, creating concerns over poor preparation for internship. Inadequate experiences may also compromise patient safety. This study explores variances in procedural entrustment of medical students between core clerkships during the first clinical year.
Students completing their first clinical year were surveyed on procedure participation. Holistic entrustment decisions are complex, thus participation was used as an objective proxy for entrustment.
138 students responded (66% response rate); 89% (123/138) wished they had performed more procedures. Students had higher participation rates during procedural clerkships (surgery, obstetrics/gynecology). Entrustment was highest during surgery, and lowest during pediatrics. Surgery gave statistically significantly higher entrustment for subcuticular suturing (compared to obstetrics/gynecology) and nasogastric tube removal (compared to internal medicine). Entrustment was generally inversely proportional to procedure complexity within each specialty.
Students encounter higher entrustment during procedural clerkships, especially surgery. Targeted areas for increased procedural involvement can be identified in all specialties.
•Entrustment with procedures is inversely related to procedure complexity.•Surgery clerkships offer students the highest entrustment with procedures.•All clerkships can identify targets for increased student procedural involvement.
Medical students encounter higher entrustment with supervised procedures during procedural clerkships, especially surgery. Entrustment is inversely related to procedure complexity. |
| doi_str_mv | 10.1016/j.amjsurg.2020.02.052 |
| format | Article |
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Students completing their first clinical year were surveyed on procedure participation. Holistic entrustment decisions are complex, thus participation was used as an objective proxy for entrustment.
138 students responded (66% response rate); 89% (123/138) wished they had performed more procedures. Students had higher participation rates during procedural clerkships (surgery, obstetrics/gynecology). Entrustment was highest during surgery, and lowest during pediatrics. Surgery gave statistically significantly higher entrustment for subcuticular suturing (compared to obstetrics/gynecology) and nasogastric tube removal (compared to internal medicine). Entrustment was generally inversely proportional to procedure complexity within each specialty.
Students encounter higher entrustment during procedural clerkships, especially surgery. Targeted areas for increased procedural involvement can be identified in all specialties.
•Entrustment with procedures is inversely related to procedure complexity.•Surgery clerkships offer students the highest entrustment with procedures.•All clerkships can identify targets for increased student procedural involvement.
Medical students encounter higher entrustment with supervised procedures during procedural clerkships, especially surgery. Entrustment is inversely related to procedure complexity.</description><identifier>ISSN: 0002-9610</identifier><identifier>EISSN: 1879-1883</identifier><identifier>DOI: 10.1016/j.amjsurg.2020.02.052</identifier><identifier>PMID: 32139105</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Clerkships ; Complexity ; Decision making ; Entrustment ; Gynecology ; Internal medicine ; Likert scale ; Medical students ; Medicine ; Obstetrics ; Patient safety ; Pediatrics ; Phlebotomy ; Psychiatry ; Statistical analysis ; Student participation ; Students ; Supervised procedures ; Surgery ; Sutures ; Technical skills ; Undergraduate medical education</subject><ispartof>The American journal of surgery, 2020-09, Vol.220 (3), p.537-542</ispartof><rights>2020 Elsevier Inc.</rights><rights>Copyright © 2020. Published by Elsevier Inc.</rights><rights>2020. Elsevier Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c393t-f2d3ddcf3db12e9f6a871b986171065c473e87aabf66ad7e8918607a5ff595033</citedby><cites>FETCH-LOGICAL-c393t-f2d3ddcf3db12e9f6a871b986171065c473e87aabf66ad7e8918607a5ff595033</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0002961020301331$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65534</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32139105$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Foote, Darci C.</creatorcontrib><creatorcontrib>Reddy, Rishindra M.</creatorcontrib><creatorcontrib>Matusko, Niki</creatorcontrib><creatorcontrib>Sandhu, Gurjit</creatorcontrib><title>Surgery clerkship offers greater entrustment of medical students with supervised procedures than other clerkships</title><title>The American journal of surgery</title><addtitle>Am J Surg</addtitle><description>Medical student procedural participation is increasingly limited, creating concerns over poor preparation for internship. Inadequate experiences may also compromise patient safety. This study explores variances in procedural entrustment of medical students between core clerkships during the first clinical year.
Students completing their first clinical year were surveyed on procedure participation. Holistic entrustment decisions are complex, thus participation was used as an objective proxy for entrustment.
138 students responded (66% response rate); 89% (123/138) wished they had performed more procedures. Students had higher participation rates during procedural clerkships (surgery, obstetrics/gynecology). Entrustment was highest during surgery, and lowest during pediatrics. Surgery gave statistically significantly higher entrustment for subcuticular suturing (compared to obstetrics/gynecology) and nasogastric tube removal (compared to internal medicine). Entrustment was generally inversely proportional to procedure complexity within each specialty.
Students encounter higher entrustment during procedural clerkships, especially surgery. Targeted areas for increased procedural involvement can be identified in all specialties.
•Entrustment with procedures is inversely related to procedure complexity.•Surgery clerkships offer students the highest entrustment with procedures.•All clerkships can identify targets for increased student procedural involvement.
Medical students encounter higher entrustment with supervised procedures during procedural clerkships, especially surgery. Entrustment is inversely related to procedure complexity.</description><subject>Clerkships</subject><subject>Complexity</subject><subject>Decision making</subject><subject>Entrustment</subject><subject>Gynecology</subject><subject>Internal medicine</subject><subject>Likert scale</subject><subject>Medical students</subject><subject>Medicine</subject><subject>Obstetrics</subject><subject>Patient safety</subject><subject>Pediatrics</subject><subject>Phlebotomy</subject><subject>Psychiatry</subject><subject>Statistical analysis</subject><subject>Student participation</subject><subject>Students</subject><subject>Supervised procedures</subject><subject>Surgery</subject><subject>Sutures</subject><subject>Technical skills</subject><subject>Undergraduate medical education</subject><issn>0002-9610</issn><issn>1879-1883</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFkctuFDEQRS0EIkPgE0CW2LDpxo9pd3uFUBQIUiQWwNry2OWMm35MXHZQ_h5HM2SRDatSlU9dl-4l5C1nLWdcfRxbO49Y0k0rmGAtEy3rxDOy4UOvGz4M8jnZMMZEoxVnZ-QV4lhbzrfyJTmTgkvNWbchtz-qBKR76iZIv3EfD3QNARLSmwQ2Q6Kw5FQwz7XWJzqDj85OFHPxdYT0T8x7iuUA6S4ieHpIqwNfEiDNe7vQNe-ryqM8viYvgp0Q3pzqOfn15fLnxVVz_f3rt4vP142TWuYmCC-9d0H6HRegg7JDz3d6ULznTHVu20sYemt3QSnrexg0HxTrbRdCpzsm5Tn5cNStB90WwGzmiA6myS6wFjRC9lupqg28ou-foONa0lKvM2IrtVaD1qxS3ZFyaUVMEMwhxdmme8OZecjEjOaUiXnIxDBhaiZ1791Jveyqe49b_0KowKcjANWOuwjJoIuwVBdjApeNX-N_vvgLGSSiaA</recordid><startdate>20200901</startdate><enddate>20200901</enddate><creator>Foote, Darci C.</creator><creator>Reddy, Rishindra M.</creator><creator>Matusko, Niki</creator><creator>Sandhu, Gurjit</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20200901</creationdate><title>Surgery clerkship offers greater entrustment of medical students with supervised procedures than other clerkships</title><author>Foote, Darci C. ; Reddy, Rishindra M. ; Matusko, Niki ; Sandhu, Gurjit</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c393t-f2d3ddcf3db12e9f6a871b986171065c473e87aabf66ad7e8918607a5ff595033</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Clerkships</topic><topic>Complexity</topic><topic>Decision making</topic><topic>Entrustment</topic><topic>Gynecology</topic><topic>Internal medicine</topic><topic>Likert scale</topic><topic>Medical students</topic><topic>Medicine</topic><topic>Obstetrics</topic><topic>Patient safety</topic><topic>Pediatrics</topic><topic>Phlebotomy</topic><topic>Psychiatry</topic><topic>Statistical analysis</topic><topic>Student participation</topic><topic>Students</topic><topic>Supervised procedures</topic><topic>Surgery</topic><topic>Sutures</topic><topic>Technical skills</topic><topic>Undergraduate medical education</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Foote, Darci C.</creatorcontrib><creatorcontrib>Reddy, Rishindra M.</creatorcontrib><creatorcontrib>Matusko, Niki</creatorcontrib><creatorcontrib>Sandhu, Gurjit</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Foote, Darci C.</au><au>Reddy, Rishindra M.</au><au>Matusko, Niki</au><au>Sandhu, Gurjit</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Surgery clerkship offers greater entrustment of medical students with supervised procedures than other clerkships</atitle><jtitle>The American journal of surgery</jtitle><addtitle>Am J Surg</addtitle><date>2020-09-01</date><risdate>2020</risdate><volume>220</volume><issue>3</issue><spage>537</spage><epage>542</epage><pages>537-542</pages><issn>0002-9610</issn><eissn>1879-1883</eissn><abstract>Medical student procedural participation is increasingly limited, creating concerns over poor preparation for internship. Inadequate experiences may also compromise patient safety. This study explores variances in procedural entrustment of medical students between core clerkships during the first clinical year.
Students completing their first clinical year were surveyed on procedure participation. Holistic entrustment decisions are complex, thus participation was used as an objective proxy for entrustment.
138 students responded (66% response rate); 89% (123/138) wished they had performed more procedures. Students had higher participation rates during procedural clerkships (surgery, obstetrics/gynecology). Entrustment was highest during surgery, and lowest during pediatrics. Surgery gave statistically significantly higher entrustment for subcuticular suturing (compared to obstetrics/gynecology) and nasogastric tube removal (compared to internal medicine). Entrustment was generally inversely proportional to procedure complexity within each specialty.
Students encounter higher entrustment during procedural clerkships, especially surgery. Targeted areas for increased procedural involvement can be identified in all specialties.
•Entrustment with procedures is inversely related to procedure complexity.•Surgery clerkships offer students the highest entrustment with procedures.•All clerkships can identify targets for increased student procedural involvement.
Medical students encounter higher entrustment with supervised procedures during procedural clerkships, especially surgery. Entrustment is inversely related to procedure complexity.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>32139105</pmid><doi>10.1016/j.amjsurg.2020.02.052</doi><tpages>6</tpages></addata></record> |
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| source | Elsevier ScienceDirect Journals |
| subjects | Clerkships Complexity Decision making Entrustment Gynecology Internal medicine Likert scale Medical students Medicine Obstetrics Patient safety Pediatrics Phlebotomy Psychiatry Statistical analysis Student participation Students Supervised procedures Surgery Sutures Technical skills Undergraduate medical education |
| title | Surgery clerkship offers greater entrustment of medical students with supervised procedures than other clerkships |
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