Medical Student Perceptions of Effective and Ineffective Educators during their Surgical Clerkship

doi:10.21203/rs.3.rs-4953859/v1

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Research Article

Medical Student Perceptions of Effective and Ineffective Educators during their Surgical Clerkship

https://doi.org/10.21203/rs.3.rs-4953859/v1

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Purpose

While the operative experience is a core component of the surgical clerkship, studies have suggested interactions with strong teachers and mentors have the most significant impact on a student’s decision to pursue a surgical career. The goal of this study was to identify qualities of effective and ineffective educators from a medical student’s perspective and clarify successful educational techniques that can significantly impact medical students’ surgery clerkship experiences.

Methods

We conducted a qualitative analysis of all medical student Surgery clerkship evaluations of resident physicians and surgery faculty from 2018 to 2022 at four HMS affiliated tertiary care centers. We utilized grounded theory as a means of exploring and interpreting our data. Qualitative analysis was conducted with two reviewers per the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist guidelines for qualitative research.

Results

A total of 1,378 faculty evaluations were analyzed with a Cohen’s Kappa of 0.85, indicating excellent inter-rater reliability. The analysis revealed six key themes that resonated with medical students during surgical clerkships: Enabling Student Involvement, Investment in Student Learners, Positive Team Environment, High Yield Teaching, Clinical Role Models, and Personal Connection. Students valued educators who allowed independence, advocated for their involvement, and engaged with them both inside and outside the operating room. Effective educators prioritized educational experiences, set clear expectations, and provided feedback. They also shaped the team environment by including students and acknowledging their contributions. Successful teaching strategies included high-yield chalk-talks, multi-modal activities, and personalized topics. Students appreciated educators who demonstrated clinical excellence and sought personal connections, valuing mentorship and efforts to know them as individuals.

Conclusions

Medical Student

Surgical Clerkship

Surgical Education

Resident Educator

Surgical Faculty

The surgical clerkship is often a medical student’s first exposure to the surgical specialties and can have a significant impact on their perception and interest in surgery^1–5. During the surgical clerkship, medical students are exposed to a variety of operations, surgical patient encounters, and team interactions with attendings and residents³. While the operative experience is a core component of the surgical clerkship, the interactions with good teachers and mentors typically have the most significant impact on a student’s decision to pursue a surgical field^6–11. Medical students with more exposure to highly ranked resident teachers were more likely to pursue a career in surgery⁷. Similarly, students who identified working with good resident teachers not only had overall better clerkship scores but also expressed greater interest in a surgical specialty⁸. Analyses of student surveys and evaluations highlighted enthusiasm, positive attitude, active involvement with the student, clinical competence, and helpful feedback as some of the important qualities of effective teachers^9–16. Overall, these studies emphasize the significant impact that educators can have on medical students’ perceptions and career choices.

It is important to note that most of the existing literature on medical student teaching during surgical clerkships is based on survey data or teaching award comments, and therefore fail to capture which teaching approaches specifically are most effective for medical students^6–16. This information is needed to train successful surgical educators and ensure that resident physicians and faculty are aware of not only which techniques they should be using, but also which ones to avoid. Therefore, there is a need to delineate actionable teaching strategies that are identified by medical students and can be successfully implemented by resident physicians and attending surgeons. The goal of this study was to identify what medical students perceive as qualities of effective and ineffective educators based on student evaluations during the general surgery clerkship.

Surgical Clerkship Structure

Upon entering Harvard Medical School (HMS), students are randomly placed into one of three HMS-affiliated tertiary care centers for their main clinical clerkships. Additionally, a group of 10–15 students opt into the HMS-Cambridge Integrated Clerkship, offering a continuous longitudinal clerkship model at a community hospital affiliated with HMS. Following 14 months of pre-clinical foundational courses, students embark on a year of clinical rotations at their assigned hospitals. The surgical clerkship lasts three months and includes a four-week rotation in either General Surgery or Trauma, a week each in anesthesia and the intensive care unit, two weeks in the emergency department, and a final four weeks dedicated to elective rotations. These electives are chosen by the students and cover a range of surgical specialties including Orthopaedics, Plastic Surgery, Ophthalmology, Otolaryngology, and Neurosurgery. The curriculum during the surgical clerkship also features weekly educational sessions and simulations led by a team of faculty, fellows, resident physicians, and senior medical students. At the end of their surgical rotation, students are required to evaluate the resident and attending physicians with whom they had significant interactions.

Student Resident and Faculty Evaluation Data Collection

We conducted a qualitative analysis of medical student Surgery clerkship evaluations of resident physicians and surgery faculty from 2018 to 2022 at four HMS affiliated tertiary care centers. Evaluations of anesthesia residents and faculty were excluded. IRB approval was obtained from the Mass General Brigham (MGB) IRB as well as permissions from the HMS Academy Research Group and HMS Surgery Education Committee. All evaluation data was anonymized using an honest data broker (EP).

Qualitative Analysis

We utilized grounded theory as a means of exploring and interpreting our data. Qualitative analysis was conducted with two reviewers per the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist guidelines for qualitative research¹⁶. Coding was performed by DP and AP, with Dedoose (SCRC, Los Angeles, CA) as our code management software. Both reviewers were General Surgery resident physicians and Massachusetts General Hospital (MGH) Surgery Education Research Fellows who were experienced in performing qualitative surgical education research. Before and during data analysis, both coders considered how their personal contexts as surgical residents and surgical education researchers might affect their interpretation of the data.

DP and AP independently reviewed the first 200 faculty evaluations, focusing on identifying educator qualities that impacted the student experience, and developed preliminary codes. Next, the coders independently continued reviewing evaluations until no new codes emerged, suggesting they had reached saturation. Upon completion of independent coding, DP and AP collaborated to unify their codebooks and then coded all of the evaluations. The two coders then cooperatively developed categories and, later, themes from these codes.

A total of 1,378 faculty evaluations were collected. Inter-rater reliability testing resulted in a Cohen’s Kappa of 0.85, indicating an excellent level of reliability. Twenty-three codes were consistently present throughout the data within six clear themes representing educator qualities and teaching techniques that resonated with medical students during their surgical clerkships: Enabling Student Involvement, Investment in Student Learners, Positive Team Environment, High Yield Teaching, Clinical Role Models, and Personal Connection (Table 1). These themes are organized based on the frequency of the codes they represent, with the themes containing more frequent codes discussed first and with the least frequent codes last. An overview of the relative code frequencies can be found in Fig. 1. Quotes included in the results are transcribed as written in the student evaluations. Given the anonymization of the data, student responses are not credited to specific student evaluations.

Table 1

Data Themes, Codes, and Corresponding Definitions
Theme	Codes	Definition
Enabling Student Involvement	Independence	Students appreciate when the educator gives them the autonomy to act and think independently, and do not appreciate when educators do not provide this opportunity.
	Engagement	Educator invites student to participate in skills practice, direct patient care, hands on learning experiences, and the OR.
	Advocate	Advocates for student to be involved in patient care.
	Preparation	Aids the student in preparing for their rotation (ie. OR cases, patient care, clinic, etc).
Investment in Student Learners	Feedback	Educator provides frequent, constructive, actionable feedback.
	Expectation Setting	Strong educators set clear expectations for the rotation and the student's role on the team.
	Challenging	Challenges the student to improve within a supportive environment.
	Prioritization of Education	Carves out time or adds time to the work day for teaching regardless of the busyness or stress of the service.
Positive Team Environment	Team Inclusion	The educator facilitates integration of the student into the surgical team and makes them feel welcome in the surgical environment.
	Psychological Safety	The educator creates a safe environment where the student feels comfortable approaching them, making mistakes, and asking questions.
	Clear Communication	Communicates clearly with the student and whole team regarding daily tasks and expectations.
	Positive Attitude	Educator is described as enthusiastic and having a positive attitude towards teaching, as well as toward their job in general. Also includes when the student describes a negative attitude as a detriment.
	Value Acknowledgement	Recognizes the value the student adds to the team, and expresses gratitude.
High Yield Teaching	Meaningful Teaching	Educator provides teaching on high yield topics or skills to prepare students for the surgery clerkship. Avoids non-educational tasks.
	Personalized Teaching	Elicits goals from the students and tailors educational experiences toward student's goals and/or interests.
	Multi-modal Teaching	Utilizes different forms of teaching, including formal didactics/lectures, in-the-moment instruction or discussion, literature investigation, etc.
	Questions	Uses questions to probe fund of knowledge and prompt further learning.
Clinical Role Models	Clinical Excellence	Student describes the educator as modeling excellence for patient care and in the OR.
	Professionalism	Students appreciate when educators model professionalism toward the team and their patients, and are disappointed when unprofessional behaviors are modeled.
	Thought Process	Provides insight and explanations to the decision-making and critical thinking that is needed when providing patient care.
Personal Connection	Personal Investment	Sees the student as a whole person, takes the time to get to know them personally.
Personal Connection	Mentorship	Student describes the educator as providing career advice or guidance.

Theme #1: Enabling Student Involvement

Students most frequently commented on how effective educators encouraged and enabled them to be hands-on in their learning. To set the student up for success, the best resident and attending educators would help them prepare for their operative experiences (See Appendix 1:1a for specific quote). Most importantly, for some students, the unique environment of the operating room (OR) can be particularly intimidating. With the educator’s guidance, students can feel more confident and comfortable in the OR, therefore maximizing their educational experience.

Resident educators in particular also acted as advocates to encourage student involvement in patient care. Their position as leaders of the inpatient team can be used to empower student engagement (see Appendix 1:1b). Excellent educators advocated for their student by encouraging them to be involved in the operation, guiding them as to the right time to scrub in, and checking in to make sure they were comfortable. This kind of investment in the student’s educational experience is very impactful to students’ perception of learning and acceptance on the surgical clerkship.

Additionally, the best educators allowed the students an appropriate level of autonomy. These experiences included independently seeing patients, presenting histories, working on notes, or assisting with procedures (see Appendix 1:1c). When educators trusted students to act independently, the students eagerly rose to the occasion and the opportunities to practice the skills they had observed were valued as great educational experiences.

Correspondingly, students were especially discouraged by residents or attendings who did not make an effort to engage them. As mentioned previously, students sought opportunities to help the team and act independently, but to do so often required the encouragement from their educator. Unfortunately, not all students had educators who welcomed their involvement (see Appendix 1:1d). When students described neglect, it was consistently a similar experience of feeling like an outsider, not encouraged to participate in the day-to-day activities of the team. Therefore, when residents or attendings showed disinterest, students similarly became disinterested and disheartened.

Theme #2: Investment in Student Learners

By taking small steps to ensure their students were set up for success, faculty left students with the impression that they were genuinely invested in their educational experience. The strongest educators would start the student’s rotation by delineating expectations for their role on the team (see Appendix 1:2a). Often, these students did not have previous exposure to surgery, so setting these guidelines helped them feel better prepared to take on their surgical rotations. Additionally, eliciting the student’s personal goals helped align their interests with the educator’s objectives.

As the student continued on the service, these expectations were best maintained by providing regular feedback. Students often commented on how honest, actionable feedback would inspire them to improve (see Appendix 1:2b). Students sought feedback from their educators, however, not all faculty provided appropriate feedback. As noted in the previous quote, good feedback was constructive, specific, and gave the student the opportunity to improve and build upon what they had learned. Students often noted when faculty would either not provide feedback or provided ineffective feedback: (see Appendix 1:2c). Students saw feedback as an opportunity for growth, so being deprived of that opportunity was particularly disheartening. When educators gave clear expectations and feedback on their progress, students were motivated to push themselves as learners (see Appendix 1:2d). By challenging their students to succeed, educators showed investment in their students’ growth, which in turn led the students to believe in their own potential.

In addition, one of the most impactful ways educators demonstrated investment in the students was by prioritizing their education. Students recognized that the clinical day was often busy, which made the moments faculty took time to teach particularly meaningful (see Appendix 1:2e). Therefore, teaching does not always have to be structured, but rather small teaching moments throughout the day maximized the student’s educational experience. On the other hand, the most common complaint was when educators would not make this effort (see Appendix 1:2f). Similar comments were common throughout the evaluations, and highlight how much students valued when teaching is prioritized. It is important to note that students often recognize that busy days are not always conducive to teaching, and therefore the strongest educators were those who found a way to incorporate student learning into those demanding clinical schedules.

Theme #3: Positive Team Environment

The team dynamic is one of the most unique aspects of surgical culture, and students viewed surgical educators as responsible for setting the tone of that environment. There were several ways students mentioned their faculty would positively contribute to the environment. First, and most commonly noted, was establishing a psychologically safe environment. The strongest educators allowed the students to feel comfortable and confident asking questions and sharing their curiosity. This was important of both resident and attending physicians. Residents often would set the tone outside of the OR. (see Appendix 1:3a). On the other hand, students saw the role of the attending as directing the atmosphere inside of the OR during cases (see Appendix 1:3b). In both instances, students appreciated being able to learn in an environment where they were encouraged to ask questions, and could be wrong without repercussions. The safe space allowed their curiosity and interest in surgery to grow.

Similarly, students greatly valued when their resident physicians would make them feel “like a welcome part of the team”. Resident educators would do so by involving them in tasks, and by acknowledging them as a valuable addition to the team’s productivity. Additionally, attending educators would welcome students into the operating room, and interact with them during cases. Actively involving students as team members inspired them to be more engaged and proactive when contributing to patient care but likely requires dedicated pre-clinical instruction to maximize each student’s knowledge and effectiveness.

Another important aspect of the team dynamic is effective communication. Students often noted that strong educators were able to lead their team by clearly delegating roles and tasks to each member (see Appendix 1:3c). For students, this effective communication helped define their role within the team and therefore allowed them to maximally contribute and learn.

In general, the team environment was significantly impacted by the overall attitude of the surgical educator. Residents and attending educators with positive attitudes towards teaching inspired similar excitement in the students they taught (see Appendix 1:3d). However, the opposite was also true; negative attitudes were toxic to the team dynamic (see Appendix 1:3e). Students reflected the attitudes put forth by their educators in that positive leaders similarly led to enthusiastic students, while negative outlooks would cloud the student’s surgical experience.

Theme #4: High Yield Teaching

There were several different teaching strategies that students noted effective educators employed. First was providing what felt like meaningful teaching. Students would commend when educators provided practical or “high yield” teaching points on topics relevant to the cases they would see that day or would need to know for their exams (see Appendix 1:4a). In doing so, students felt that the educator’s time and their time were being used effectively to focus on only the most pertinent surgical knowledge to understand.

Similarly, students appreciated when teaching was personalized to their interests or needs. Educators effectively elicited those interests by asking students if there were any particular topics they were hoping to learn or experience early in the rotation (see Appendix 1:4b). By tailoring teaching to the student’s preferences, the educator showed interest in the student as an individual. This approach has the benefit of helping students feel engaged and personally connected to them as individuals.

Within the OR, students felt the best educators would teach using focused questions. This use of teaching scripts was the most common way students noted they would have the opportunity to interact with attendings. Questioning in the OR would help keep students engaged, focus their learning, and clarify areas where they could continue to grow (see Appendix 1:4c). Since the OR was the most common environment where students interacted with attendings, active Socratic questioning sessions were also one of a students’ few opportunities to highlight their medical knowledge and technical skills. Therefore, the use of standardized questioning scripts by attending surgeons also allowed fair student assessments and constructive feedback opportunities.

Another often commented-on technique was using multi-modal teachings strategies. In other words, rather than only relying on chalk talks or intra-operative teaching alone, strong educators would use a variety of teaching strategies and techniques (see Appendix 1:4e). These teaching strategies helped keep student learners engaged and interested in varying settings. This method was a particularly effective way that educators could incorporate teaching moments within a busy clinical schedule.

Theme #5: Clinical Role Models

This theme highlights how medical students turn to faculty to exemplify clinical acumen and skill. Students frequently noted when educators personified clinical excellence, both inside and outside of the OR. Intra-operatively, students were attuned to the technical skills attendings and resident physicians demonstrated (see Appendix 1: 5a). Specifically, students often appreciated when educators would share their thought process around different clinical situations, and many saw this as significantly contributing to their learning. In particular, students noted when educators would not explain the “why” when making clinical decisions, and frequently gave this as constructive feedback for educator improvement (see Appendix 1:5b). Students valued when educators provide glimpses into their surgical decision-making so they could similarly begin to develop those skills themselves.

The medical students noted that a surgical educator displayed clinical excellence not only through technical skills and knowledge, but also through their interactions with peers, patients, and the students themselves (see Appendix 1:5c). Teacher behaviors such as showing respect, kindness, and professionalism towards everyone, truly distinguished a role model in the eyes of medical students. Such a view emphasizes how these students look to surgical educators to learn not only technical skills and medical knowledge, but also how to behave as a surgeon.

Theme #6: Personal Connection

Residents and attendings that made an effort to establish personal connections with the students were greatly valued. Educators showed interest in the student as a person by eliciting their goals within medicine, discussing their hobbies outside of the hospital, and assuaging their fears or anxieties about surgery (see Appendix 1:6a). In getting to know the students personally, educators could also tailor their teaching towards the student’s interests and goals to maximize their learning. On the other hand, although infrequent, students were particularly offput when their resident or attending made no effort to connect with them (see Appendix 1:6b). This indifference from the faculty not only led to the student’s diminished interest in that particular rotation, but also in the field of surgery as a whole.

At times, residents and attendings would go beyond their roles as teachers to become mentors (see Appendix 1:6c). Students who found mentors among their educators often cited this connection as leading to their own decisions to pursue a career in surgery (see Appendix 1:6d). Excellent educators passed on their knowledge freely, inspiring medical students to follow in a similar path.

Medical students’ resident physician and faculty evaluations revealed many characteristics of effective and ineffective surgical educators. Although there were some differences in the educational roles of residents and attendings, the student evaluations revealed successful educational techniques that all educators should utilize to significantly impact medical students’ surgery clerkship experiences.

Residents versus Attending Educators

Attending surgeons and resident physicians have significant roles in the students’ experiences, however, they appear to have slightly different educational domains. For example, medical students perceived residents as having the largest impact on day-to-day clinical activities, patient care, and inpatient team dynamic. Since students spent most of their time with their resident educators, the majority of the dedicated educational time was often a responsibility of the resident. This finding is supported by prior studies that similarly reported students see residents as their primary source of patient care education¹⁸. Additionally, residents had the largest influence on incorporating the student into the surgical team and providing them opportunities to be involved in patient care. As suggested by existing literature^9–16, the strongest resident educators were those who recognized their unique position and empowered students to be engaged, grow, and succeed.

On the other hand, students viewed the attending surgeons as leading the educational experience in the OR. A prior study conducted by Schwind and colleagues investigating the medical student experience in the OR specifically similarly found that the learning environment was most significantly influenced by the attending’s tone, teaching ability, and amount of interaction with the student¹⁹. Our findings add additional insight into how attendings specifically impact the operative environment as educators. Importantly, OR team members likely see the OR as a working environment whereas students see the OR as a learning environment. Therefore, attending surgeons may require additional training to help create a psychologically safe environment in the OR to allow the student to feel comfortable and welcome. This training would likely benefit all learners in the OR including resident physicians, nurse trainees, and anesthesia residents or CRNA trainees. Similarly, attending surgeons could likely benefit from training in the use of Socratic questioning in the OR to bring out the best engagement in both medical students and resident physicians. One possible solution is the use of standardized teaching scripts which are prepared teaching topics or questions for particular cases or situations. Utilizing prepared teaching scripts can help minimize the cognitive load of engaging the medical student for surgical educators.

Our results highlight that both resident physicians and attending surgeons have significant roles in the educational experience of medical students. Further, our students recognized both residents and attendings provided meaningful mentorship during the clerkship and beyond. As prior studies have noted, identifying residents and attendings as role models not only improves the student’s clerkship experience, but also increases the likelihood they pursue a career in surgery themselves^19,20.

Ineffective Educators

When students identified ineffective educators, there was one prevailing theme they all had in common: they failed to engage the medical student. This lack of engagement presented in a variety of ways, including not taking time for teaching moments, providing feedback, interacting with them in the OR, or giving students opportunities to be involved in patient care. There are likely many possible reasons for essentially ignoring students as investing in medical student education takes time, and the increased time demand and lack of teaching compensation on top of a clinically demanding schedule are clear barriers to surgical educators^21,22.

The Surgical Educator’s Compass

We have summarized the findings of this study into a “Surgical Educator’s Compass” which is illustrated in Fig. 2. Like an actual compass, the goal of this tool is to guide surgical educators through the phases of medical student learning. These tips are designed to require minimal time commitment from the educator, while maximizing the student’s educational experience based on the results of this study.

Before working with medical students, academic institutions should provide resident and attending faculty development opportunities to educate them on effective teaching and feedback strategies. If not provided by their institution, motivated educators should seek educational resources to be knowledgeable and prepared for student teaching. Some examples of educational courses and resources can be found in the American College of Surgeons and Association for Surgical Education websites^24–26. Before the start of the clerkship, clerkship leadership should organize student orientation to involve basic surgical skill practice, such as knot tying and suturing, to help students feel confident and prepared before going into the OR. This preparation has the added benefit of giving the educators a foundation on which to continue to help guide the student’s technical skill development.

At the start of the surgical clerkship, an effective surgical educator should establish a safe space for curiosity. Educators can establish a psychologically safe environment by encouraging questions and responding with positivity and patience. This is the first step in the toolkit purposefully; by establishing a safe space, students will be more receptive to the educational tips that follow. A psychologically safe environment is what will make the difference between engagement and mistreatment^27–29. Similarly, educators should recognize students as members of the team. Simply acknowledging the student’s role in the inpatient team, and particularly noting their value to the team’s efficacy, can make a significant difference in the student’s perception of belonging. Lastly, educators should begin rotations by setting clear expectations. Appropriate expectations can include the student’s rounding responsibilities, role in caring for floor patients, and expected preparation for the OR. Taking time at the start of the rotation to delineate the medical student’s roles and responsibilities has the benefit of aligning the expectations of the educator with the goals of the student.

Throughout the surgical clerkship, the surgical educator should provide regular, actionable constructive feedback. Setting aside time at least once in the middle of the rotation to provide feedback on the student’s performance helps the student feel that the educator is invested in their education and growth. Ideal feedback should be immediate, actionable, based on observed behaviors, and include both positive observations, and areas for improvement^30,31. Ideally, surgical educators should make time for short teaching points. Students noted and appreciated when the educator made an effort to incorporate teaching moments throughout the day. This practice could take varying forms and varying amounts of time, from chalk talks, to suturing skills practice, to surgical decision-making explanations during rounds, or anatomy reviews before entering the OR. As described above, surgeons in particular should take the time to prepare questions for the operating room. Having a set of questions prepared to ask the student throughout the operation can help keep the student interested and highlight the educational takeaways from the case. Resident education leaders should take the time to designate independent student tasks. Some examples of appropriate student tasks include interviewing patients, assisting with clinical notes, or assisting with procedures they have observed, such as placing NG tubes, pulling drains, or suturing. Allowing student autonomy in patient care can benefit the teams as a whole, and is often a highlight of their surgical clerkship experience. Lastly, both attending surgeons and resident physicians should try to get to know the student as a person. Asking the student about their medical interests, clinical experiences so far, and hobbies can go a long way. By eliciting the student’s goals and interests, both inside and outside of the hospital, a genuine connection can be formed between the medical student and educator, potentially leading to a mentoring relationship.

Following the student’s clerkship experience, these mentorships can continue to grow, leading to meaningful, long-term connections. Medical student relationships may also persist even if the student does not pursue a surgical career and the student may eventually become a surgeon’s referring provider or consultant. Lastly, as a component of continued faculty development, educators should be given the opportunity to regularly review their student’s evaluations. By reflecting on the student’s feedback, attendings and residents can themselves continue to refine their teaching strategies and grow as effective educators.

Limitations

There are limitations to this study. First, the evaluations were originally organized in alphabetical order prior to anonymization, and the coders both independently agreed they had reached saturation in the data after reading through approximately 2/3rds of the evaluation. Therefore, there is a possibility that new codes could have emerged in the later alphabetical faculty’s evaluations. However, saturation had been reached for over 100 evaluations prior to discontinuing coding, making this bias unlikely. The main limitation is this study was based on evaluation data from students from a single medical school, therefore limiting the generalizability of our findings. However, many of our main themes were supported by existing literature, suggesting our results are likely applicable to medical student experiences at other institutions. Lastly, while our results highlight lack of engagement as a defining quality of ineffective educators, it fails to capture the motivations behind these behaviors. As mentioned earlier, we hypothesize that time and compensation are two key barriers to engaging medical students. However, future investigations should aim to identify what factors lead to the differences in educators’ interests in work with medical students.

Surgical residents and attendings play a significant role in shaping the educational experience of medical students on the surgical clerkship. Based on our findings, we developed the “Surgical Educator’s Compass” to provide practical guidelines for educator interventions to incorporate varied teaching strategies, involve medical students, and maximize student education during the surgical clerkship. By enabling more residents and attendings to become effective educators, we in turn can inspire a new generation of medical students about the rewards and challenges associated with a surgical career and a surgeon’s important patient care role in modern medical practice.

Harvard Medical School (HMS) ; Mass General Brigham (MGB); Operating Room (OR)

Data Availability Statement:

The data that support the findings of this study are available from Harvard Medical School, however, given that the data contained identifiable information about the students and educators, the data is not available to the public.

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Reviewers invited by journal
15 Oct, 2024
Editor invited by journal
02 Oct, 2024
Editor assigned by journal
04 Sep, 2024
First submitted to journal
26 Aug, 2024

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Medical Student Perceptions of Effective and Ineffective Educators during their Surgical Clerkship

Status:

Version 1

Abstract

Purpose

Methods

Results

Conclusions

Figures

Introduction

Methods

Surgical Clerkship Structure

Student Resident and Faculty Evaluation Data Collection

Qualitative Analysis

Results

Theme #1: Enabling Student Involvement

Theme #2: Investment in Student Learners

Theme #3: Positive Team Environment

Theme #4: High Yield Teaching

Theme #5: Clinical Role Models

Theme #6: Personal Connection

Discussion

Residents versus Attending Educators

Ineffective Educators

The Surgical Educator’s Compass

Limitations

Conclusion

Abbreviations

Declarations

References

Supplementary Files

Status:

Version 1