Perception of educational value in clinical rotations by medical students

Figures & data

Table 1 Graduate and undergraduate entry and numbers in rural clinical school (1 year in penultimate year of medical course)

Medical students	Did not spend time in RCS	Spent time in RCS	Total
Undergraduate	24	11	35
Graduate	12	7	19
Total	36	18	54

Abbreviation: RCS, rural clinical school.

Figure 1 Clinical training sites: students’ perception of comparative educational value (5-point Likert scale)

Table 2 Clinical training sites: students’ perception of comparative educational value (5-point Likert scale)

Placement	RCS students	Purely metro students	Combined	Independent samples t-test
Metropolitan hospital (Level 3) wards	4.22	4.33	4.3	0.503
Metropolitan hospital (Level 3) outpatient clinics	3.72	3.56	3.61	0.468
Allied health (e.g., physiotherapy, occupational therapy) sessions	2.56	2.83	2.74	0.508
Metropolitan general practice	3.37	4.19	4	0.000
Rural general practice	4.22	4.27	4.25	0.576
Regional hospital (Levels 1 and 2)	4.76	4.22	4.49	0.039
Nursing attachments (e.g., to diabetes educator)	2.89	2.68	2.75	0.491
Community placements (e.g., hospices, aged care homes)	2.47	2.48	2.48	0.908
Private practice rooms	2.80	3.39	3.22	0.097
Indigenous health placements	4.30	3.66	3.98	0.061

Abbreviation: RCS, rural clinical school.

Table 3 Clinical training sites: reasons for students’ perception of comparative educational value

Why did you find this venue/these venues educationally useful to your clinical training? (tick all that apply)	Response count (%)			Independent samples t-test
Answer options	Rural	Metro	Combined	Differences between rural and metro
Being part of a clinical team	94.4	72.2	79.6	0.000
Amount of patient contact	66.7	83.3	77.8	0.011
Various patient presentations	77.8	75.0	75.9	0.438
Working with junior doctors (e.g., interns)	77.8	75.0	75.9	0.438
High level of supervision in training	83.3	63.9	70.4	0.002
Amount of formal bedside teaching/teaching ward rounds	72.2	69.4	70.4	0.767
Amount of clinical tutorials with and without patients	55.6	72.2	66.7	0.051
Opportunity to ask questions and receive useful information	55.6	72.2	66.7	0.051
Having access to patient information on the site (laboratory and radiology results)	44.4	77.8	66.7	0.023
Having peers to work with and share information/experiences	55.6	63.9	61.1	0.436
Being on call with team to admit acute patients	61.1	50.0	53.7	0.193
Regular feedback on progress in the clinical arena	33.3	58.3	50.0	0.138
Centralized medical/clinical school sessions to consolidate learning	33.3	41.7	38.9	0.505
Having good information services support including on-site library	22.2	41.7	35.2	0.004
Having junior students to mentor and consolidate learning	38.9	25.0	29.6	0.061
Frequent formative assessments (e.g., Mini-CEX, case reports)	16.7	8.3	11.1	0.067

Table 4A All students

Which of the following clinical placements did you find MOST educationally useful to your clinical training? (tick the most useful only)	Response (%)	Response (n)
Metropolitan hospital (Level 3) wards	56.6	30
Rural general practice	15.1	8
Regional hospital (Levels 1 and 2)	11.3	6
Other clinical placements	7.5	4
Metropolitan hospital (Level 3) outpatient clinics	5.7	3
Allied Health (e.g., physiotherapy, occupational therapy sessions)	1.9	1
Private practice rooms	1.9	1
Nursing attachments (e.g., to diabetes educator)	0	0
Community placements (e.g., hospices, aged care)	0	0
Indigenous health placement	0	0
Metropolitan general practice	0	0

Notes: Clinical training sites: students’ perception of highest educational value. One person did not answer this question; there were 53 responses in total for this question.

Table 4B Fully metropolitan students

Stratified data from metropolitan students	Response (%)	Response (n)
Metropolitan hospital (Level 3) wards	60.0	21
Other clinical placements	11.4	4
Rural general practice	8.6	3
Metropolitan hospital (Level 3) outpatient clinics	8.6	3
Regional hospital (Levels 1 and 2)	5.7	2
Allied Health (e.g., physiotherapy, occupational therapy sessions)	2.9	1
Private practice rooms	2.9	1
Nursing attachments (e.g., to diabetes educator)	0	0
Community placements (e.g., hospices, aged care)	0	0
Indigenous health placement	0	0
Metropolitan general practice	0	0

Notes: Clinical training sites: students’ perception of highest educational value. One person did not answer this question; there were 35 responses in total for this question.

Table 4C Students with 1 year in rural clinical school

Stratified data from rural students	Response (%)	Response (n)
Metropolitan hospital (Level 3) wards	50.0	9
Rural general practice	27.8	5
Regional hospital (Levels 1 and 2)	22.2	4
Other clinical placements	0	0
Metropolitan hospital (Level 3) outpatient clinics	0	0
Allied health (e.g., physiotherapy, occupational therapy sessions)	0	0
Private practice rooms	0	0
Nursing attachments (e.g., to diabetes educator)	0	0
Community placements (e.g., hospices, aged care)	0	0
Indigenous health placement	0	0
Metropolitan general practice	0	0

Note: Clinical training sites: students’ perception of highest educational value.

Table 5A All students

Why did you find this venue the most educationally useful to your clinical training? (tick all that apply)	Response (%)	Response (n)
Amount of patient contact	84.9	45
Various patient presentations	83.0	44
Being part of a clinical team	66.0	35
Opportunity to ask questions and receive useful information	62.3	33
High level of supervision in training	60.4	32
Amount of formal bedside teaching/teaching ward rounds	58.5	31
Amount of clinical tutorials with and without patients	50.9	27
Working with junior doctors (e.g., interns)	43.4	23
Regular feedback on progress in the clinical arena	41.5	22
Having peers to work with and share information/experiences	39.6	21
Having access to patient information on the site (laboratory and radiology results)	39.6	21
Being on call with team to admit acute patients	37.7	20
Having junior students to mentor and consolidate learning	22.6	12
Centralized medical/clinical school sessions to consolidate learning	20.8	11
Having good information services support including on-site library	15.1	8
Frequent formative assessments (e.g., Mini-CEX, case reports)	9.4	5
Other reason(s)	1.89	1

Notes: Clinical training sites: reasons for students’ perception of educational value. One person did not answer this question; there were 53 responses in total for this question.

Table 5B Fully metropolitan students

Stratified data from metropolitan students	Response (%)	Response (n)
Amount of patient contact	82.9	29
Various patient presentations	82.9	29
Opportunity to ask questions and receive useful information	65.7	23
Being part of a clinical team	62.9	22
High level of supervision in training	57.1	20
Amount of formal bedside teaching/teaching ward rounds	57.1	20
Amount of clinical tutorials with and without patients	54.3	19
Working with junior doctors (e.g., interns)	45.7	16
Having access to patient information on the site (laboratory and radiology results)	42.9	15
Regular feedback on progress in the clinical arena	40.0	14
Having peers to work with and share information/experiences	37.1	13
Being on call with team to admit acute patients	37.1	13
Centralized medical/clinical school sessions to consolidate learning	22.9	8
Having junior students to mentor and consolidate learning	17.1	6
Having good information services support including on-site library	11.4	4
Frequent formative assessments (e.g., Mini-CEX, case reports)	11.4	4
Other reason(s)	0.0	0

Notes: Clinical training sites: reasons for students’ perception of educational value. One person did not answer this question; there were 35 responses in total for this question.

Table 5C Students with 1 year in rural clinical school

Stratified data from rural students	Response (%)	Response (n)
Amount of patient contact	88.9	16
Various patient presentations	83.3	15
Being part of a clinical team	72.2	13
High level of supervision in training	66.7	12
Amount of formal bedside teaching/teaching ward rounds	61.1	11
Opportunity to ask questions and receive useful information	55.6	10
Amount of clinical tutorials with and without patients	44.4	8
Regular feedback on progress in the clinical arena	44.4	8
Having peers to work with and share information/experiences	44.4	8
Working with junior doctors (e.g., interns)	38.9	7
Being on call with team to admit acute patients	38.9	7
Having junior students to mentor and consolidate learning	33.3	6
Having access to patient information on the site (laboratory and radiology results)	33.3	6
Having good information services support including on-site library	22.2	4
Centralized medical/clinical school sessions to consolidate learning	16.7	3
Frequent formative assessments (e.g., Mini-CEX, case reports)	5.6	1
Other reason(s) – high student/teacher ratio	5.6	1

Note: Clinical training sites: reasons for students’ perception of educational value.

Table 6 Frequencies of activities in clinical placements (5-point Likert scale)

Frequency of activities in clinical placements	Combined	Rural	Metro
Present acute patients to a senior doctor	3.39	3.39	3.39
Report daily on your allocated patients’ progress	2.70	2.78	2.67
Participate in teaching ward rounds	3.44	3.44	3.44
Attend intern training sessions	3.74	3.72	3.75
Attend resident training sessions	3.06	3.00	3.08
Attend postgraduate sessions including Grand Rounds	3.87	3.67	3.97
Review specifically prepared online cases to consolidate learning	2.93	2.67	3.06
Participate in learning blogs supervised by a clinician	1.40	1.12	1.53
Participate in learning blogs with other students only	1.51	1.24	1.64
Participate in a dedicated Facebook page for learning issues	1.09	1.06	1.11

Table 7 Educational value of clinical activities (5-point Likert scale)

Activities	Combined	Rural	Metro
Present acute patients to a senior doctor	4.77	4.89	4.71
Report daily on your allocated patients’ progress	4.19	4.41	4.06
Participate in teaching ward rounds	4.19	4.50	4.03
Attend intern training sessions	4.22	4.00	4.33
Attend resident training sessions	3.79	3.53	3.93
Attend postgraduate sessions including Grand Rounds	3.38	3.35	3.40
Review specifically prepared online cases to consolidate learning	3.94	3.86	3.97
Participate in learning blogs supervised by a clinician	2.67	2.33	2.78
Participate in learning blogs with other students only	2.57	2.33	2.64
Participate in a dedicated Facebook page for learning issues	1.89	1.00	2.00

Table 8 Frequencies of assessments during clinical placements

In your clinical rotations, how frequently were the following assessments used to examine your clinical knowledge?	1 – Never	2 – Rarely (<10%)	3 – Some rotations (10%–45%)	4 – Most rotations (50%–90%)	5 – Every rotation	Rating average
Short case examinations	0	0	16	27	11	3.91
Continuous performance assessment	3	7	6	18	20	3.83
Long case examinations	0	0	21	25	8	3.76
Logbooks	0	4	13	32	5	3.70
Paper-based exams	2	9	23	11	9	3.30
Objective structured clinical examinations/multiple station assessment tasks	4	8	21	15	6	3.20
Oral (non-patient based) examinations	11	14	17	9	3	2.61
Portfolios	13	16	16	8	1	2.41