title: Clinical exposures during internal medicine acting internship: profiling student and team experiences.
abstract: BACKGROUND
  The clinical learning model in medical education is driven by knowledge acquisition through direct patient-care experiences. Despite the emphasis on experiential learning, the ability of educators to quantify the clinical exposures of learners is limited.
  
  
  OBJECTIVE
  To utilize Veterans Affairs (VA) electronic medical record information through a data warehouse to quantify clinical exposures during an inpatient internal medicine rotation.
  
  
  METHODS
  We queried the VA clinical data warehouse for the patients encountered by each learner completing an acting internship rotation at the Cleveland VA Medical Center from July 2008 to November 2011. We then used discharge summary information to identify team exposures-patients seen by the learner's inpatient team who were not primarily assigned to the learner. Based on the learner and team exposures, we complied lists of past medical problems, medications prescribed, laboratory tests that resulted, radiology evaluated, and primary discharge diagnoses.
  
  
  RESULTS
  Primary learner and team-based clinical exposures were evaluated for a total of 128 acting internship students. The percentage of learners who had a primary exposure to a medication/lab value/imaging result/diagnosis was calculated. The percentage of learners with at least 1 primary or team-based exposure to an item was also calculated. The most common exposures in each category are presented.
  
  
  CONCLUSIONS
  Analysis of the clinical exposures during an inpatient rotation can augment the ability of educators to understand learners' experiences. These types of analyses could provide information to improve learner experience, implement novel curricula, and address educational gaps in clinical rotations.
authors.affiliation: Medical Service, Louis Stokes Cleveland Department of Veterans Affairs Medical Center, and Department of Medicine, Case Western Reserve School of Medicine, Cleveland, Ohio.
authors.forename: Todd I
authors.initials: TI
authors.lastname: Smith
authors.forename: Charles M
authors.initials: CM
authors.lastname: LoPresti
mesh_terms: D057286:Electronic Health Records / Q000639:trends; D006787:Hospitals, Veterans / Q000639:trends; D006801:Humans; D007388:Internal Medicine / Q000193:education*; D007396:Internship and Residency / Q000379:methods*; D005791:Patient Care / Q000379:methods* / Q000639:trends; D013337:Students, Medical; D014481:United States; D014493:United States Department of Veterans Affairs / Q000639:trends