Well I can only say what I do as a senior/chief:
I tell them all right off that they can come and go as they please; they’re adults and if they’d rather go home and study then that’s up to them. I try to provide a value added experience that merits their time. If it doesn’t, then I trust them to make that call.
I have resorted to offering my above and beyond experiences via email after the rotation ends. These are things like taking them to the tbone lab to drill or a
Fresh cadaver lab to work on soft tissue skills. To ensure nobody feels obligated, i make the offer and ask that they email me after the rotation to set up a time. Seems to ensure that only the really interested reach out which is what I want.
For the others I try to shape their rotation based on their career plans. Everyone gets OR time but people bound for non surgical fields get a little more relevant clinic time if they want it.
I try to prep for cases with students so they see what it looks like to read for a case. Nobody taught me how to do this but I wish they had. We go through atlases, videos, imaging, hpi, etc. I try to give them specific things to review.
Intraop I try to assign students to cases where they can participate. This may mean retracting or soft tissue closure. I want them to learn skills and anatomy that’s meaningful while also in putting them where additional hands are helpful. For us, free flaps are great for students because they are big sites so easy to see, and there’s lots of sewing to be done while the fellows sew vessels. Great time to teach sewing and soft tissue handling.
I do lots of pimping as well so they are engaged and thinking. We run clinical scenarios and go through high yield chalk talks.
For true sub-i rotators I have them do all the notes and orders under my login while I watch them like a hawk. I want to give them a taste of intern year and the scut involved. It takes longer than doing it myself but I think it’s good learning.
