The Most Valuable Critical Incidents in a 4th-Year Acting Internship in Surgery

Background: Most physicians recall specific learning events, such as patient encounters or instructional encounters, that profoundly affected their education. Formal analysis of these events may have important implications in optimizing a 4th-year acting internship in surgery (AIS). Purpose: We sought to identify and analyze critical learning events (CLEs) in an AIS. Methods: Students were asked to describe the most valuable learning experience that occurred during their AIS rotation. The 122 responses underwent critical event analysis, generating 6 categories: (a) procedures, (b) didactics, (c) call, (d) patient and perioperative care, (e) clinic, and (f) other. The critical incident category was analyzed for relations to the assigned clinical service, performance on written examination and clinical evaluation, as well as student specialty training selected upon graduation. Results: The most frequently cited critical incidents were patient and perioperative care events. The frequency of critical event themes expressed by AIS students varied by the service on which they rotated. Critical event themes varied by student's future specialty choice. Conclusions: Understanding CLEs in the clinical years provides an opportunity to improve clinical rotations and student schedules, to accommodate individual learning preferences.