title: Preoperative assessment clinic: a missed learning opportunity?
abstract: BACKGROUND
  Day-case surgery, theatre direct admissions and elective surgery have revolutionised the surgical patient's pathway, and have minimised the length of their hospital stay. However, with large numbers of medical students placed mostly at teaching hospitals, this has also significantly reduced students' exposure to clinical signs in surgery. This study aimed to assess whether the preoperative assessment clinic would be an appropriate teaching arena to offer medical students exposure to clinical signs.
  
  
  METHODS
  Junior doctors assigned to the preoperative assessment clinic were asked to fill out a specially designed questionnaire for each patient they reviewed. This included the planned operation, presenting complaint, and identification and categorisation of objective clinical signs on examination. The assessor was asked whether the patient was suitable for, and amenable to, having medical students observe. The presenting complaints and clinical signs were referenced to the curriculum for Oxford University's second Bachelor of Medicine examinations (finals).
  
  
  RESULTS
  Of the 100 patients seen in 40 clinics, only four refused to be seen by a medical student. Of the remaining patients, 89 (92%) had presenting complaints listed on the core curriculum for Oxford University. Seventy-six (79%) patients had objective clinical signs on examination. Only three patients (3%) had neither clinical signs nor core relevant presenting complaints.
  
  
  CONCLUSIONS
  The results clearly demonstrate that preoperative assessment is an arena that would give medical students two important opportunities: to examine objective clinical signs and to take histories of presenting complaints from the core curriculum. This learning opportunity would otherwise be missed.
authors.affiliation: Department of Surgery, John Radcliffe Hospital, Oxford Deanery, 48 New High Street,Oxford, UK. jessamy.bagenal@gmail.com
authors.forename: Jessamy
authors.initials: J
authors.lastname: Bagenal
authors.forename: Zoe
authors.initials: Z
authors.lastname: Barber
authors.forename: Kapil
authors.initials: K
authors.lastname: Sahnan
authors.forename: Ashok
authors.initials: A
authors.lastname: Handa
mesh_terms: D000556:Ambulatory Surgical Procedures / Q000379:methods*; D002983:Clinical Competence; D006801:Humans; D010808:Physical Examination; D057234:Preoperative Period; D013337:Students, Medical