ORIGINAL REPORTS Action of Student–Resident Interaction During a Surgical Clerkship Roy E. Gandy, MD, William O. Richards, MD, and Charles B. Rodning, MD Department of Surgery, College of Medicine and Medical Center, University of South Alabama, Mobile, Alabama BACKGROUND: This study is a qualitative assessment of the effect of clinical encounter documentation cards on medical student-surgical resident interaction during the core surgical clerkship, junior medical school year. METHODOLOGY: The implementation of a clinical encoun- ter documentation card system occurred during academic year 2009 –2010. The results were compared with historical control medical student cohorts from antecedent academic years. The perceptions of overall quality of the clerkship and effectiveness of residents as teachers were assessed using a psychometric Lik- ert scale. RESULTS: Ninety percent of the medical students and surgical residents “agreed” or “strongly agreed” that the educational value of clinical encounters was enhanced by the documenta- tion card system. DISCUSSION: Junior medical students receive a substantial and valuable portion of their formal surgical education from surgical residents. We argue that this documentation card sys- tem tangibly increased the educational value of clinical encoun- ters and improved the cognitive, technical, and rhetorical skills of both medical students and surgical residents. CONCLUSION: We submit that this clinical encounter doc- umentation card system: improved each student’s educational experience and each resident’s teaching ability; provided valu- able information about residents as teachers; facilitated more refined assessment of their performance in relationship to the core competencies; provided timely information permitting ad- justments of clinical service assignments during each rotation; and “clinical context teaching moments” were perceived as a valuable element of the core surgical clerkship. (J Surg 67: 275-277. © 2010 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.) KEYWORDS: clinical encounter, documentation cards, teach- ing moments, residents as teachers COMPETENCY: Patient Care, Medical Knowledge, Profes- sionalism, Interpersonal and Communication Skills, Practice- Based Learning and Improvement INTRODUCTION Undergraduate medical students receive a substantial portion of their formal education from residents, especially during their core clerkships/junior medical school year. Effective teaching and mentoring by residents have been demonstrated to improve students’ performance and influence career choices positively. 1 We designed and implemented a documentation card system to evaluate the educational value of clinical encounters and the effectiveness of resident teaching during core surgical clerkships for junior medical students during academic year 2009 –2010. This study was designed to evaluate the effectiveness of cards as an assessment tool to document (1) clinical encounters by jun- ior medical students during their core surgical clerkship, (2) surgical resident effectiveness as teachers, and (3) the edu- cational quality of those clinical encounters and teaching activities. METHODOLOGY At the beginning of each 8-week core surgical rotation, 12–16 junior medical students were provided 2 types of index cards. The Observed Clinical Encounter Card (CE) listed the clinical context, resident involvement, feedback provided, and an over- all assessment (Fig. 1). CE documented intrahospital general surgical consultations, the evaluation and management of trauma patients, outpatient clinical assessments, and the perfor- mance of intraoperative or at-bedside procedures. CE listed the attending faculty or resident involved and the clinical context. Our definition of “clinical encounter” was broadly construed to encompass situations where students were actively evaluating and caring for surgical patients. Feedback and comments from observing faculty or residents were recorded on the cards. The Resident as Teacher Card (RT) listed the student’s overall as- sessment of the resident’s teaching and feedback during a par- ticular clinical encounter (Fig. 2). Correspondence: Inquiries to Roy E. Gandy, MD, College of Medicine and Medical Center, University of South Alabama, Mastin Building Room 714, 2451 Fillingim St, Mobile, AL 36617; fax: (251) 471-7842; e-mail: rgandy@usouthal.edu Journal of Surgical Education • © 2010 Association of Program Directors in Surgery 1931-7204/$30.00 Published by Elsevier Inc. All rights reserved. doi:10.1016/j.jsurg.2010.07.003 275