Involving med students in hospital work doesn't slow procedures

Last year, a study published in the Journal of the American Medical Association found the presence of medical students in emergency departments has little effect on length of operations. Now a new study by the team, also published in JAMA, has corrected for what a letter to the editor says were omissions in the initial study model.

Patricia McGettigan, M.D., and Jean McKendree, Ph.D., of Queen Mary University of London, noted in a letter to the editor that while the authors of the original study provided ED data, they did not include information about actual student activity within the ED during the study period or whether they were present simply to observe. "Without knowledge of how the clerkship worked, even the length of stay outcome has little value for hospital planners or educators," they wrote.

Researchers on the original study, led by Kimon L. H. Ioannides of the University of Pennsylvania Perelman School of Medicine, conducted a new version that addressed McGrettigan and McKendree's concerns, this time in a rehabilitation unit, which they acknowledge is a considerably different setting than the ED. Student subjects were divided into three groups. The first group worked under a second-year resident for multiple shifts, but presented directly to an attending physician. All students at the second and third hospitals presented directly to attending physicians and in many cases self-assigned patient evaluations upon admission.

Ioannides and colleagues found no significant change in length of stay between the three hospitals, suggesting the original study results apply with variation in levels of student involvement. "We believe this early exposure to the acute care setting is an invaluable educational experience for medical students and a prime setting for developing basic clinical skills," they wrote.

To learn more:
- read the abstract