[Consequences drawn from the evaluation of logbook-based surgical training for final year students]

Abstract

Background: The current training programme for final year medical students does not meet the requirements of surgery and is obviously not able to encourage young physicians to become surgeons. After finishing the surgical trimester, the motivation to become a doctor decreases considerably more strongly than after any other specialty during the final year programme. This emphasises the urgent need for a consequent redesign involving modern educational programmes.

Method: The present article represents a systematic analysis of 70 logbooks used by final year medical students, which accompanied them during the surgical trimester from August 2008 to December 2009 at the Department of Surgery at the University of Greifswald, Germany. This analysis was subsequently compared to an evaluation of the same students as to how valuable the logbook was for their surgical education by means of an anonymous questionnaire.

Results: The results indicate that the general quality of education during the surgical trimester was evaluated to be high, but that the use of a logbook in the current mode did not contribute to enhance medical/surgical training programmes. Although most of the requested examinations and procedures were carried out by at least 70 % of the students, less than half of them had the impression that the use of this specific logbook improved their education. The students ask for a more intense interaction with the tutor/mentor and request differentiated discussions about their personal stronger and weaker spots, as well as more bedside teaching, e. g., the terms of training ward rounds with the consultant surgeon. Besides, they demand more supervised practical skill training in contrast to the often commonly practiced "learning by doing".

Conclusion: The logbook is a powerful and effective educational tool able to structure and examine medical training and skills. But the present evaluation of the surgical logbook indicates that there is a need to adapt the current version to student's and institution's requirements. Otherwise it will only be seen as a purely labour intensive obligation, which will consequently lead to frustration and will not enrich the surgical training programme within the final year of medical school.