A systematic comparison of teaching hospital and remote-site clinical education

This paper present a methodology for examining activities of medical students on multisite clinical clerkships to determine whether differences exist in the educational experience offered at various sites. Five criterion variables are explored: distribution of student activities, type or class of clinical conditions encountered by students, degree of "esoterism" of those conditions, type of student role, and flexibility of student role. A format for data collection, employing a specially designed activity recording pad, was developed as part of the study. Application of this method to a clerkship in obstetrics and gynecology documents the existence of systematic differences in the educational experiences offered at different sites, particularly with regard to type of activities undertaken and conditions encountered. Most notably, the results suggest that it is fallacious to dichotomize clerkship sites as "academic" or "community" based. It is found that community hospitals themselves can differ markedly and offer an experience paralleling that of the academic referral center.