The day-to-day education of medical students is delivered by large numbers of personnel. The impact of this on student learning experiences remains unclear. The aim of this study was to determine how students spent their time during a Perioperative Care attachment, encompassing the disciplines of Gastrointestinal and Vascular Surgery, and Anaesthesia. 

Students participating in the study self-completed a 5-day diary during a Perioperative Care attachment. They recorded each learning encounter noting the duration, the setting and details about the supervisor. Participants also rated the perceived educational value of each learning encounter.

35 students returned completed diaries between February and May 2012. Students spent on average 33 hours (range 26-47) in learning encounters over the 5-day period assessed. They spent a mean of 15 hours per week (range 0-37) in the operating theatre, a mean of 14 hours (range 0-29) on the wards and a mean of 3 hours (range 0 - 10) in outpatient clinics. The perceived educational value was rated as good or very good with the following frequencies: theatre 86%, wards 84% and clinics 92%. Multi-disciplinary team meetings received the lowest ranking of all educational encounters (61% good or very good), although minimal time was spent in this setting (mean 1 hour, range 0-5). Students spent a mean of 25 hours (range 0-42) and 9 hours (range 0-36) in surgical and anaesthetic learning encounters respectively. Students rated the perceived educational value of the surgical and anaesthetic encounters as good or very good, 82% and 93% of the time respectively. The majority of student education was consultant led (mean 23 hours, range 10-38). The remainder was delivered by specialist registrars (mean 4 hours, range 0-21), other junior doctors (mean 3 hours, range 0-12) and allied healthcare professionals (mean 1 hour, range 0-6). Students were unsupervised for a mean of 3 hours (range 0 - 13). There were no significant differences in perceived educational value of encounters according to the supervisor with all categories of supervisors receiving ratings of good or very good over 80% of the time.

There was significant heterogeneity in student encounters during the course of a Perioperative Care attachment. In spite of this, students did not report major differences in perceived educational value between the different learning environments.

Heterogeneity of medical student experiences during a clinical attachment does not appear to impact on education.