Author response: Incorporating students into clinic may be associated with both improved clinical productivity and educational value.

Abstract Background: In this study, we aimed to evaluate ambulatory clinic responsibilities that neurology clerkship students perceive as having the highest educational value and to evaluate the association between a student9s presence and level of responsibility and a preceptor9s clinical and financial productivity during a clinic session. Methods: Physician preceptors (n = 43) and medical students (n = 67) in the Johns Hopkins Neurology clerkship from 2014 to 2015 were included. Students rated their experience and responsibilities in 291 neurology clinic sessions. Productivity metrics (e.g., relative value units [RVU]/clinic) were collected for each preceptor in the presence and absence of students. Results: A student9s rating of a clinic as an effective learning experience increased with each additional patient the student interviewed (odds ratio [OR] 1.89, p p p p = 0.026), presented (β = 2.42, p = 0.047), and documented (β = 2.70, p = 0.036) by students. On average, preceptor RVU/session increased by 42% (mean 5.6 ± 1.2, p p p Conclusions: This observational study suggests a mutual benefit to preceptor clinical productivity and student-perceived educational value when students have active responsibilities in neurology clinics. Despite concerns that students slow down preceptors in clinic, these results suggest that preceptors may have an overall boost in productivity, potentially by performing billable work while students independently see patients.