Do strong resident teachers help medical students on objective examinations of knowledge?

Background: Despite a lack of formal training, surgical residents at our institution have an integral role instructing medical students on their general surgery clerkship. It is unknown how the instruction provided by surgical residents affects the students' testable knowledge base and performance on standardized surgical examinations. The purpose of this survey study was to evaluate the impact of surgical resident teachers on medical student performance on the National Board of Medical Examiners surgery shelf examination.

Study Design: Surveys were provided to all third-year medical students completing an 8-week clerkship in general surgery. Students were asked to rate the quality and quantity of instruction received from surgical residents. Resident instruction was evaluated in several categories using a 5-point Likert scale. Analyses were conducted to evaluate the impact of survey responses on student percentile scores on the surgery shelf examination.

Results: Seventy-five of 110 (67.3%) students completed the surveys over a period of 22 months. Forty-two individual residents were evaluated in several categories, and an overall teaching evaluation was completed. The mean shelf percentile score by the medical students was 48.1 ± 31.4 (range, 1st to 98th percentile). Using univariate analyses, no individual resident factors or overall factors had a significant effect on student performance. A regression analysis revealed that overall quality of instruction had a significantly positive impact on student performance (p = 0.038). Individual residents and increasing PGY level had a significantly negative impact on the students' shelf performance (p < 0.001). The model R(2) showed our model to predict only 13.8% of the student's examination score variability.

Conclusions: A statistically significant relationship exists between student performance on the shelf examination and their perception of the overall quality of instruction that they receive from surgical residents. However, this seems to account only for a small portion of the variability in student percentile scores.