Background/Introduc.on
EM placements are popular with UK medical students, and Elec7ves/Student Selected Components allow longer placements than the standard curriculum.
We wished to explore the rela7onship between student sa7sfac7on with these longer ED placements, type of hospital, stage of training and availability of opportuni7es and supervision.
Method
Using social media, we appealed for medical students who had undertaken an EM placement of at least four weeks in dura7on in the last five years to complete an online ques7onnaire (n=35).
Using a scale of 1 (strongly disagree) to 10 (strongly agree) respondents rated their agreement with a series of statements about learning opportuni7es in ED & competencies acquired.
Results
Overall, 29/35 (83%) said their EM placement was “a highlight of medical school”. These students were more likely to have seen pa7ents afresh, and had significantly easier access to supervision (t (33) = 2.17, p < 0.05).
Both these factors were more commonly reported by students whose EM placement was in a District General Hospital (DGH) cf. city teaching hospital.
Among students who undertook their EM placement in the final two years of medical school, 94% said it was a highlight, significantly more than the 64% whose placement was earlier in their medical school career.
More senior students reported fewer problems accessing ED doctors with capacity to handle pa7ents they had clerked.
Conclusion
Student sa7sfac7on with an Emergency Medicine placement is a complex combina7on of departmental culture, learning opportuni7es, quality of supervision and case-‐mix.
Our findings confirm that access to supervision is integral to student sa7sfac7on & hints that more junior students encounter difficul7es in finding doctors free to present cases to. Teaching hospital placements score poorly regarding student sa7sfac7on compared with DGHs, but this may be skewed by junior students being significantly more likely to have undertaken a teaching hospital placement rather than DGH.
We suspect the tradi7onal ED “see & present” placement is less suitable for junior medical students & less rewarding for ED doctors supervising them, influencing the lower sa7sfac7on expressed by junior students. Alterna7ve models for hos7ng junior medical student placements in ED should be considered: recruitment difficul7es to the specialty will be compounded if those who ac7vely seek EM placements as junior medical students do not enjoy them, and it it known that many students make commiZed career decisions early in medical school (Ref 1).
Reference 1. Zeldow, P. B., Preston, R. C., & Daugherty, S. R. (1992). The decision to enter a medical specialty: timing and stability. Medical Education, 26, 327-‐332.
Photo: Aneurin Bevan Health Board