There's No Modern Substitute For Some Old-fashioned One-on-one

The study, published in the June issue of American Surgeon, points to a powerful, but often overlooked, tool for influencing students’ attitudes about their surgical training in school.

Peter Ehrlich, M.D., MSc., an associate professor of pediatric surgery at the U-M Medical School, and colleagues found that the quality of the student-teacher interaction was the main reason behind a positive experience during the clinical training portion of the curriculum.

“What I really learned from this study is that what students wanted 20 or 30 years ago and still want today is for instructors to interact with them. Even with all the modern day technology in teaching tools, nothing can replace face-to-face contact,” says Ehrlich.

Students were more likely to recommend a rotation to other students and enjoyed their experience more if an instructor spent time with them, challenged them to think, provided useful feedback, and had a positive attitude toward students and teaching.

“It didn’t matter if subjects were male or female, or if they had any previous career interests in surgery; what really made the difference was whether teachers spent time with them,” says Ehrlich.

The study also found that students listed medicine and surgical subspecialties as their most common career interests and one quarter of the participants had a pre-existing interest in surgery. According to Ehrlich, this stresses the importance of clinical training in attracting students to a surgical career, since there is a sizable pool of potential surgeons.

Another interesting finding was that males were four times more likely to have a prior interest in surgery than females. According to previous studies conducted by other groups, one influence on a female student’s choice of specialty may be that women experience more gender discrimination and sexual harassment during undergraduate education.

“Surgery is still a male-dominated profession, and this should also be addressed,” says Ehrlich, “The surgical and clinical experiences in medical school must be monitored carefully to ensure that half the potential pool of future surgeons is not turned off by a surgical career.”

During the study, 113 students at the West Virginia University School of Medicine completed a 27-question survey to evaluate their experience after clinical training. They had nine surgical areas to pick from and each student trained in four of these for a total of 452 surveys.

The questionnaire was surgery-specific and included questions about general surgical tasks, demographic information, students’ pre-existing interests, and subjective and objective questions about various components of being a surgeon and the student-teacher interaction. In addition, they had to evaluate the teacher.

Ehrlich created the survey because he felt that a better review of the quality of education was needed. Currently, students take surveys a year or more after their clinical experience and the questions are broad and generic. These evaluations are often used to influence promotions, tenure, and important changes to the curriculum.

“We always get evaluations from students about teaching, but a year or two after their clinical training, and there’s no difference between the surveys for different areas of clinical training. I felt this made them fairly meaningless,” says Ehrlich.

Ehrlich, who also teaches surgery to medical students, believes that instructors who take an interest in students and their educational needs can really influence career choices.

“When you find a teacher who really turns you on to a particular field, that’s what you end up doing. I had a teacher in medical school who really made an impression on me and he’s one of the main reasons I’m a pediatric surgeon today.”

The study was co-authored by PA Seidman, M.D. from the West Virginia University School of Medicine, where Ehrlich served as director of surgical and medical education before coming to U-M.