Society of Asian Academic Surgeons Identification of Specific Educational Targets to Improve the Student Surgical Clerkship Experience Sophia K. McKinley, MD, EdM, a, * Douglas J. Cassidy, MD, a Arian Mansur, a Noelle Saillant, MD, a Arundhati Ghosh, MD, b Amy Evenson, MD, MPH, c Reza Askari, MD, d Alex Haynes, MD, MPH, e Nancy Cho, MD, d Benjamin C. James, MD, MS, c Jaisa Olasky, MD, f Erika Rangel, MD, d Emil Petrusa, PhD, a and Roy Phitayakorn, MD, MHPE a a Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts b Harvard Medical School, Cambridge, Massachusetts c Department of Surgery, Harvard Medical School, Boston, Massachusetts d Harvard Medical School, Boston, Massachusetts e Department of Surgery, Mount Auburn Hospital, Harvard Medical School, Cambridge, Massachusetts f Department of Surgery, Dell Medical School, University of Texas, Austin, Texas article info Article history: Received 12 December 2019 Received in revised form 12 March 2020 Accepted 31 March 2020 Available online xxx Keywords: Clerkship Undergraduate medical education Medical students Clinical education abstract Background: This study describes the relationship between medical student perception of sur- gery, frequency of positive surgery clerkship activities, and overall surgical clerkship experience. Methods: Medical students at four academic hospitals completed pre- and post-clerkship surveys assessing 1) surgery clerkship activities/experiences and 2) perceptions of sur- gery during the 2017-2018 academic year. Results: Ninety-one percent of students completed both a pre- and post-clerkship survey (n ¼ 162 of 179). Student perception of surgery significantly improved across the clerkship overall (P < 0.0001) and for 7 of 21 specific items. Eighty-six percent of students agreed that the clerkship was a meaningful experience. Sixty-six percent agreed that the operating room was a positive learning environment. Multivariable logistic regression identified one- on-one mentoring from a resident (OR [95% CI] ¼ 2.12 [1.11-4.04], P ¼ 0.02) and establishing a meaningful relationship with a surgical patient (OR ¼ 2.21 [1.12-4.37], P ¼ 0.02) as activ- ities predictive of student agreement that the surgical clerkship was meaningful. Making an incision (OR ¼ 2.92 [1.54-5.56], P ¼ 0.001) and assisting in dissection (OR ¼ 1.67 [1.03-2.69], P ¼ 0.035) were predictive of student agreement that the operating room was a positive learning environment. Positive student perception of surgery before the clerkship was associated with increased frequency of positive clerkship activities including operative involvement (r ¼ 0.26, P ¼ 0.001) and relationships with surgical attendings (r ¼ 0.20, P ¼ 0.01), residents (r ¼ 0.41, P < 0.0001), and patients (r ¼ 0.24, P ¼ 0.003). This work was presented as an oral presentation at the Society of Asian American surgeons, Boston, September 2019. * Corresponding author. Massachusetts General Hospital, 55 Fruit Street GRB 425, Boston, MA, 02114. Tel.: þ1-617-726-2800; fax: þ1-617- 724-3499. E-mail address: skmckinley@partners.org (S.K. McKinley). Available online at www.sciencedirect.com ScienceDirect journal homepage: www.JournalofSurgicalResearch.com journal of surgical research  october 2020 (254) 49 e57 0022-4804/$ e see front matter ª 2020 Elsevier Inc. All rights reserved. https://doi.org/10.1016/j.jss.2020.03.066