title: Does clinical exposure affect medical student examination performance?
abstract: BACKGROUND
  Traditionally important components of the surgical clerkship curriculum include lectures, small-group sessions, readings, clinical exposure, and testing. Time constraints require compromise among all these elements. At our institution, clinical exposure of medical students varies according to their team assignments. They differ primarily in exposure to such topics as trauma, inflammatory bowel disease (IBD), and vascular surgery.
  
  
  OBJECTIVE
  The goal of this study was to quantify the influence of clinical exposure on medical student education, testing whether it influences examination performance.
  
  
  METHODS
  At the beginning of the clerkship, students were given a written multiple-choice examination covering these three topics. They completed two 4-week blocks on surgery services in various settings. At the end of the clerkship, they were reexamined. Differences between pretest and posttest overall mean rank were analyzed using the Wilcoxon signed ranks test. Differences in improvement based on clinical exposure were analyzed using the Mann-Whitney U test.
  
  
  RESULTS
  Statistically significant improvement was seen in overall examination performance, as well as in each of the subsections. However, these improvements could not be accounted for by clinical exposure. There was no statistically significant difference in mean rank in improvement based on clinical exposure to vascular, IBD, or trauma.
  
  
  CONCLUSIONS
  Student examination scores improved over the course of the clerkship. No improvement could be attributed to greater clinical exposure to a topic.
authors.affiliation: Department of Surgery, Mount Sinai School of Medicine, New York, New York, USA.
authors.forename: S H
authors.initials: SH
authors.lastname: Ellozy
authors.forename: S
authors.initials: S
authors.lastname: Kaiser
authors.forename: J J
authors.initials: JJ
authors.lastname: Bauer
mesh_terms: D003479:Curriculum / Q000706:statistics & numerical data; D004521:Educational Measurement / Q000379:methods / Q000706:statistics & numerical data; D013502:General Surgery / Q000193:education* / Q000706:statistics & numerical data; D006801:Humans; D007396:Internship and Residency / Q000379:methods* / Q000706:statistics & numerical data; D018709:Statistics, Nonparametric; D013337:Students, Medical / Q000706:statistics & numerical data