What Aspects of Supervised Patient Encounters Affect Students’ Perception of Having an Excellent Learning Outcome? A Survey Among European Medical Students

Figures & data

Figure 1 Flow chart of inclusion process.

Table 1 Characteristics of Sample and Those Who Scored the Learning Outcome as Excellent

Characteristics	Total	Excellent Learning Outcome
	N (%)	N (%)	p-value^a
Total	908 (100)	154 (17)
Female	653 (72)	107 (16)	0.35
Age			0.04
18–22	276 (31)	37 (13)
23–26	467 (53)	80 (17)
≥27	143 (16)	34 (24)
Proportion of medical school completed			0.18
≤a third	80 (9)	18 (23)
>a third to two thirds	340 (38)	63 (19)
>Two thirds	470 (53)	71 (15)
Year beginning to see patients (regardless of length of program)			0.004
1	284 (32)	68 (24)
2	160 (18)	24 (15)
3	389 (43)	54 (14)
>3	63 (7)	8 (13)
Country			<0.001
Norway	229 (25)	58 (26)
France	141 (16)	18 (13)
Poland^b	103 (11)	14 (14)
Hungary^b	65 (7)	10 (15)
Croatia	54 (6)	9 (17)
Belgium	49 (5)	4 (8)
Slovakia^b	38 (4)	3 (8)
Cyprus	23 (3)	5 (22)
Denmark^b	42 (5)	12 (29)
Greece	28 (3)	1 (4)
Ukraine	28 (3)	0 (0)
Other countries^b,c	104 (12)	20 (19)
Department where supervision took place			0.25
Internal medicine	245 (27)	51 (21)
Pediatrics	92 (10)	12 (13)
Surgery	74 (8)	10 (14)
Family medicine	73 (8)	18 (2)
Neurology	72 (8)	14 (19)
Obstetrics and gynecology	44 (5)	5 (11)
Orthopedics	43 (5)	8 (19)
Psychiatry	27 (3)	2 (7)
Dermatology	21 (2)	3 (14)
Oncology	20 (2)	1 (5)
Other^d	181 (20)	29 (16)
Time the supervisor was present			0.001
≥50% of time	524 (58)	109 (36)
<50% of time	376 (42)	45 (12)
Student took history and/or did examination			0.10
No	65 (7)	5 (8)
Yes	827 (93)	148 (18)
Met supervisor before			0.285
No	272 (36)	57 (21)
Yes	474 (64)	97 (20)

Notes: ^aPearson Chi-square. ^bIncludes Norwegian students abroad. Number of Norwegian respondents in Denmark (18), Hungary (54), Poland (93), Slovakia (25) and other countries (36). ^cIncluding less than 20 respondents for each of Bosnia and Herzegovina, Bulgaria, the Czech Republic, Iceland, Latvia, Malta, The Netherlands, Portugal, Romania, Slovenia, Spain, Sweden, Switzerland, Ukraine and the United Kingdom. ^dIncluding less than 20 respondents for each of Anesthesiology, Ear, nose and throat, Ophthalmology, Palliative care, Radiology, and Rehabilitation.

Table 2 Supervisor Behavior (MCTQ), Students’ Approach to Clinical Learning (CLEQ) and Psychological Safety Scores (N=908).

Characteristics	Total	Excellent Learning Outcome
		Yes	No	p-value^a
MCTQ subscales (range 1–5)
Modelling	3.55 (1.05)	4.32 (0.78)	3.39 (1.03)	<0.001
Coaching	3.72 (1.02)	4.44 (0.71)	3.58 (1.01)	<0.001
Articulation	3.46 (0.98)	4.07 (0.86)	3.34 (0.95)	<0.001
Exploration	2.75 (1.20)	3.55 (1.28)	2.59 (1.12)	<0.001
CLEQ motivation (range 1–5)	4.17 (0.51)	4.43 (0.41)	4.12 (0.52)	<0.001
Psychological safety (range 1–7)	4.93 (0.95)	5.57 (0.81)	4.80 (0.93)	<0.001

Note: Data are represented as mean (standard deviation, SD). ^aTwo-sample t-test.

Abbreviations: MCTQ, Maastricht Clinical Teaching Questionnaire; CLEQ, Clinical Learning Evaluation Questionnaire.

Table 3 Bivariable and Multivariable Logistic Regression of Variables Associated with the Dependent Variable Excellent Learning Outcome

Variables	Bivariable	Multivariable
	Crude OR	Adjusted OR^a	95% CI
MCTQ subscales
Modelling	3.45	2.14^b	1.52–3.00
Coaching	3.88	1.36	0.62–2.03
Articulation	2.61	1.06	0.76–1.48
Exploration	2.05	1.39^b	1.10–1.74
Supervisor present >50% of the time	1.93	0.97	0.61–1.55
Student took history and/or did examination	2.62	1.26	0.44–3.58
CLEQ motivation	4.41	1.74^b	1.01–3.00
Psychological safety	2.75	1.47^b	1.09–1.98
Progression
Second third	0.78	1.52	0.74–3.15
Final third	0.61	1.43	0.70–2.91
Gender
Not female	1.20	1.41	0.89–2.23
Participant group
Studies in Norway	2.21	1.73^b	1.02–2.94
Norwegian abroad	1.17	0.70	0.41–1.21

Notes: ^aMultivariable logistic regression with all variables in the model. ^b95% CI not including 1.

Abbreviations: MCTQ, Maastricht Clinical Teaching Questionnaire; CLEQ, Clinical Learning Evaluation Questionnaire; OR, odds ratio.