title: The multicenter urogynecology study on education: associations between educational outcomes and clerkship center characteristics.
abstract: OBJECTIVE
  : The objective of the study was to examine the effect of center characteristics on educational experiences and female pelvic medicine knowledge changes in third-year students at 6 medical schools.
  
  
  METHODS
  : In this secondary analysis of data acquired during a prospective, multicenter study conducted from May 2008 through June 2009, preclerkship and postclerkship third-year medical students scored their knowledge of 12 female pelvic medicine topics and 4 office procedures (knowledge scores [KSs]). Postclerkship, students also reported the number and type of learning experiences they had encountered. Participating investigators provided data on length of clerkship, number of residents, number of fellowship-trained urogynecologists, presence of a fellowship program, clerkship grading system type, presence of a urogynecology clerkship rotation, and presence of a urogynecology lecture. Analyses used Wilcoxon tests/Spearman correlation, with an α = 0.05.
  
  
  RESULTS
  : Paired preclerkship and postclerkship survey data were available for 323 students. Increased numbers of learning experiences were positively associated with number of clerkship weeks (rs = 0.22, P < 0.001), presence of a urogynecology rotation (P = 0.03), and urogynecology lecture (P < 0.001). Knowledge scores were positively associated with the number of fellowship-trained urogynecology faculty (rs = 0.17, P = 0.002) and grading system (letter grades > pass/fail) (P < 0.001). Knowledge scores were negatively associated with increasing numbers of residents (rs = -0.29, P < 0.001) and presence of a urogynecology fellowship program (P < 0.001). The center characteristics of fellowship program and number of residents were highly correlated (rs = 0.74, P < 0.001); thus, multivariate modeling was not performed.
  
  
  CONCLUSIONS
  : The presence of fellowship-trained faculty, urogynecology rotation, longer duration of clerkship, and urogynecology lecture were positively correlated with higher subjective KSs. The inverse association of KS with increased resident number and presence of fellowship was an unexpected finding.
authors.affiliation: From the *Obstetrics and Gynecology, †Urology, University of Virginia, Charlottesville, VA; ‡Obstetrics and Gynecology, University of New Mexico, Albuquerque, NM; §Obstetrics and Gynecology, Brooke Army Medical Center, San Antonio, TX; ∥Obstetrics and Gynecology, University of North Carolina, Chapel Hill, NC; ¶Obstetrics and Gynecology, University of Southern California, Los Angeles, CA; and #Obstetrics and Gynecology, University of Pittsburgh, Pittsburgh, PA.
authors.forename: Tovia Martirosian
authors.initials: TM
authors.lastname: Smith
authors.forename: Elisa R
authors.initials: ER
authors.lastname: Trowbridge
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Pastore
authors.forename: Steven C
authors.initials: SC
authors.lastname: Smith
authors.forename: Matthew C
authors.initials: MC
authors.lastname: Brennan
authors.forename: Yashika
authors.initials: Y
authors.lastname: Dooley
authors.forename: Catherine A
authors.initials: CA
authors.lastname: Matthews
authors.forename: Begum
authors.initials: B
authors.lastname: Ozel
authors.forename: Gary
authors.initials: G
authors.lastname: Sutkin
authors.forename: Kathie L
authors.initials: KL
authors.lastname: Hullfish