title: University and community hospital medical student emergency medicine clerkship experiences.
abstract: OBJECTIVE
  To determine whether there is a significant difference between educational opportunities for fourth-year medical students rotating at a university hospital (UH) compared with several community hospitals (CHs) during a mandatory emergency medicine (EM) clerkship.
  
  
  METHODS
  A self-reported clinical tool was completed in real time by each student rotating for 2 weeks at the UH and 2 weeks at 1 of 4 CHs (3 affiliated and 1 unaffiliated). Students are required to document the number of patients seen and the number of procedures performed on each of 20 six-hour shifts. They rated the EM attending clinical teaching by site using a 5-point scale at the end of the clerkship.
  
  
  RESULTS
  Most (95%) of the 87 students in the 7 clerkship blocks of the 1996-97 academic year rotated at the UH and a CH. Most (71%) students rated both the UH and the CH for the quality of teaching by attendings. There was a significant difference in the mean number of patients evaluated/shift (2.2 +/- 0.10 vs 2.8 +/- 0.10, UH vs CH; p < 0.001) and the mean number of procedures performed/shift (0.36 +/- 0.04 vs 0.56 +/- 0.05, UH vs CH; p < 0.001). Attending clinical teaching scores were significantly higher (p = 0.03) at the CHs.
  
  
  CONCLUSIONS
  The educational opportunities for students in an EM clerkship to evaluate patients and perform procedures were significantly greater at the community hospitals. Inclusion of community hospital settings in a medical student EM clerkship may optimize the clinical experience.
authors.affiliation: Department of Emergency Medicine, University of Rochester Medical Center, NY 14642, USA. elizabeth delahunta@urmc.rochester.edu
authors.forename: E A
authors.initials: EA
authors.lastname: deLahunta
authors.forename: J
authors.initials: J
authors.lastname: Bazarian
mesh_terms: D002982:Clinical Clerkship / Q000706:statistics & numerical data*; D004635:Emergency Medicine / Q000193:education*; D006764:Hospitals, Community / Q000706:statistics & numerical data*; D006785:Hospitals, University / Q000706:statistics & numerical data*; D006801:Humans; D013337:Students, Medical / Q000706:statistics & numerical data*; D014481:United States