title: The impacts of supervision, patient mix, and numbers of students on the effectiveness of clinical rotations.
abstract: OBJECTIVE
  This study investigated whether supervision, patient mix, and numbers of students influence the effectiveness of clinical rotations.
  
  
  METHODS
  The authors administered a questionnaire to 1,208 medical students in 1999 to evaluate the rotations' quality. They computed four variables--overall effectiveness, supervision, patient mix, and number of students contemporaneously involved--and analyzed the data using analysis of variance.
  
  
  RESULTS
  Supervision and patient mix positively influenced a rotation's effectiveness. A higher level of supervision and a higher level of patient mix led to higher overall effectiveness scores. The number of students did not significantly influence the effectiveness score, although a low number led to a higher score as compared with a high number. Furthermore, the two-way interaction between supervision and patient mix was significant. Supervision more strongly influenced the rotation's effectiveness when patient mix was limited than when it was high. Also, when the patient mix was limited and supervision was high, the average effectiveness score was still 7.7 (scale 1-10).
  
  
  CONCLUSIONS
  The effectiveness of clinical rotations depends on the supervision provided and patient mix, but not the number of students. Furthermore, supervision more strongly influences effectiveness when patient mix is limited than when it is high. Finally, high-quality supervision guarantees at least a sufficient score for the rotation's effectiveness, irrespective of the level of patient mix.
authors.affiliation: Department of Educational Development & Research, University of Maastricht, PO Box 616, 6200 MD Maastricht, The Netherlands. d.dolmans@educ.unimaas.nl
authors.forename: Diana H J M
authors.initials: DH
authors.lastname: Dolmans
authors.forename: Ineke H A P
authors.initials: IH
authors.lastname: Wolfhagen
authors.forename: Gerard G M
authors.initials: GG
authors.lastname: Essed
authors.forename: Albert J J A
authors.initials: AJ
authors.lastname: Scherpbier
authors.forename: Cees P M
authors.initials: CP
authors.lastname: van der Vleuten
mesh_terms: D003479:Curriculum; D004504:Education, Medical, Undergraduate; D006801:Humans; D013337:Students, Medical