The impact of medical students on work after clinic for neurology preceptors

Abstract

ObjectiveTo determine whether medical students significantly impact preceptor physicians’ clinic volume and work after clinic (WAC), we compared the time to note completion and the number of patients seen per hour (PPH) for outpatient neurologists with and without students present in their clinic. MethodsOutpatient neurologists (n = 47) involved in the Johns Hopkins Neurology Clerkship from 2015 to 2017 were included. WAC for each patient encounter was calculated as the interval between the date and time of a scheduled patient appointment and the time of clinic note completion. The number of patient encounters per scheduled clinic hour (PPH) was also calculated for each preceptor. Measurements were compared for each preceptor, serving as their own control, to account for variability in efficiency between preceptors. ResultsThere was no statistically significant difference in WAC or PPH for individual preceptors with and without students (WAC p-value = 0.837; PPH p-value = 0.139). Preceptors did see significantly more patients per day with students than without (6.28 with students, 5.07 without students, p-value <0.001). ConclusionsIn this study, assigning a student to an outpatient ambulatory clinic did not significantly increase work after clinic. In addition, students did not significantly alter the number of patients faculty saw per hour. Public Interest SummaryBoth medical students and educators have highlighted the importance of greater student involvement in clinic in providing a valuable outpatient educational experience, but it is often difficult for academic programs to recruit physician preceptors willing to teach and actively involve students in outpatient clinics. This study shows that medical student presence in clinic does not delay physician preceptors’ note completion and is not associated with less patients seen. To further optimize the outpatient educational and efficiency model, it is important for future investigations to evaluate training programs that enhance the efficacy of a student in clinic, particularly for students with less outpatient experience. This could encourage more preceptors to involve medical students in their clinic, potentially increasing student competence and interest in outpatient medicine.