scholarly journals How does preclinical laboratory training impact physical examination skills during the first clinical year? A retrospective analysis of routinely collected objective structured clinical examination scores among the first two matriculating classes of a reformed curriculum in one Polish medical school

BMJ Open ◽  
2017 ◽  
Vol 7 (8) ◽  
pp. e017748 ◽  
Author(s):  
Jolanta Świerszcz ◽  
Agata Stalmach-Przygoda ◽  
Marcin Kuźma ◽  
Konrad Jabłoński ◽  
Tomasz Cegielny ◽  
...  
Keyword(s):  
Physical Examination ◽  
Medical School ◽  
Curriculum Reform ◽  
Clinical Course ◽  
Clinical Skills ◽  
Laboratory Data ◽  
Significant Difference ◽  
Second Year ◽  
Laboratory Training ◽  
Preclinical Training

ObjectiveAs a result of a curriculum reform launched in 2012 at our institution, preclinical training was shortened to 2 years instead of the traditional 3 years, creating additional incentives to optimise teaching methods. In accordance with the new curriculum, a semester-long preclinical module of clinical skills (CS) laboratory training takes place in the second year of study, while an introductory clinical course (ie, brief introductory clerkships) is scheduled for the Fall semester of the third year. Objective structured clinical examinations (OSCEs) are carried out at the conclusion of both the preclinical module and the introductory clinical course. Our aim was to compare the scores at physical examination stations between the first and second matriculating classes of a newly reformed curriculum on preclinical second-year OSCEs and early clinical third-year OSCEs.DesignAnalysis of routinely collected data.SettingOne Polish medical school.ParticipantsComplete OSCE records for 462 second-year students and 445 third-year students.Outcome measuresOSCE scores by matriculation year.ResultsIn comparison to the first class of the newly reformed curriculum, significantly higher (ie, better) OSCE scores were observed for those students who matriculated in 2013, a year after implementing the reformed curriculum. This finding was consistent for both second-year and third-year cohorts. Additionally, the magnitude of the improvement in median third-year OSCE scores was proportional to the corresponding advancement in preceding second-year preclinical OSCE scores for each of two different sets of physical examination tasks. In contrast, no significant difference was noted between the academic years in the ability to interpret laboratory data or ECG — tasks which had not been included in the second-year preclinical training.ConclusionOur results suggest the importance of preclinical training in a CS laboratory to improve students’ competence in physical examination at the completion of introductory clinical clerkships during the first clinical year.

scholarly journals Virtual Integrated Patient: An AI supplementary tool for second-year medical students

2021 ◽  
Vol 6 (3) ◽  
pp. 87-90
Author(s):  
Juanita S. M. Kong ◽  
Boon See Teo ◽  
Yueh Jia Lee ◽  
Anu Bharath Pabba ◽  
Edmund J.D. Lee ◽  
...  
Keyword(s):  
Medical Students ◽  
Pilot Study ◽  
Physical Examination ◽  
Clinical Skills ◽  
History Taking ◽  
Clinical Rotations ◽  
Face To Face ◽  
Second Year ◽  
Standardised Patients ◽  
Real Patients

Introduction: With the COVID-19 pandemic, Singapore underwent a national lockdown in which most organisations, including schools were closed. Halting face-to-face tutorials resulting in decreased clinical contact for medical students. Prior to the pandemic, we had developed the Virtual Integrated Patient (VIP). Equipped with conversational technology, it provides students online practice in various clinical skills such as history-taking, physical examination and investigations. The aim of this paper is to describe the supplementary use of VIP in the second-year class, in which a pilot study was conducted. Methods: The VIP platform was introduced to the cohort and used to supplement the teaching of history-taking in the “Communication with Patients” (CWP) module for second-year students. Traditionally, CWP tutorials involve face-to-face history-taking from standardised patients (SPs). Students, who consented to participating in the trial, had an additional 3 weeks’ access to VIP to practice their history-taking skills. They completed a survey on their user experience and satisfaction at the end of the 3 weeks. Results: Out of the 106 participants, 87% strongly agreed or agreed that using VIP helped in remembering the content while 69% of them felt that VIP increased their confidence and competence in history-taking. Conclusion: VIP was well-received by students and showed promise as a tool to supplement history-taking tutorials, prior to students’ encounter with SPs and real patients. Hence, this trend showed its potential as an alternative when clinical rotations were delayed or cancelled. Further research can be done to evaluate its effectiveness in this context.

scholarly journals Generalizability of a Progress Clinical Skills Examination and the Assessment of the Growth in Clinical Skills in a Medical School Curriculum with Early Clinical Experiences

2019 ◽  
Author(s):  
Heather S Laird-Fick ◽  
Chi Chang ◽  
Ling Wang ◽  
Carol Parker ◽  
Robert Malinowski ◽  
...  
Keyword(s):  
Medical School ◽  
Repeated Measures ◽  
Clinical Skills ◽  
Clinical Skill ◽  
Skills Training ◽  
Longitudinal Growth ◽  
First Year ◽  
Clinical Experiences ◽  
First Year Students ◽  
Second Year

Abstract Background This study evaluates the generalizability of an eight-station progress clinical skills examination and assesses the growth in performance for six clinical skills domains among first- and second-year medial students over four time points during the academic year. Methods We conducted a generalizability study for longitudinal and cross-sectional comparisons and assessed growth in six clinical skill domains via repeated measures ANOVA over the first and second year of medical school. Results The generalizability of the examination domain scores was low but consistent with previous studies of data gathering and communication skills. Variations in case difficulty across administrations of the examination made it difficult to assess longitudinal growth. It was possible to compare students at different training levels and the interaction of level of training and growth. Second-year students outperformed first-year students, but first-year students’ clinical skills performance grew faster than second-year students narrowing the gap in clinical skills over the students’ first year of medical school. Conclusions Case specificity limits the ability to assess longitudinal growth in clinical skills through progress testing. Providing students with early clinical skills training and authentic clinical experiences appears to result in the rapid growth of clinical skills during the first year of medical school.

scholarly journals Comparison of OSCE Performance Between 6- and 7-Year Medical School Curricula in Taiwan

2021 ◽  
Author(s):  
Jr-Wei Wu ◽  
Hao-Min Cheng ◽  
Shiau-Shian Huang ◽  
Jen-Feng Liang ◽  
Chia-Chang Huang ◽  
...  
Keyword(s):  
Medical Students ◽  
Medical School ◽  
Curriculum Reform ◽  
Clinical Skills ◽  
School Curriculum ◽  
Medical School Curriculum ◽  
Eligibility Criteria ◽  
The Impact ◽  
Clinical Internship ◽  
Internship Training

Abstract BackgroundThe year 2013 marks a watershed in the history of medical education in Taiwan. Following Taiwan's Taskforce of Medical School Curriculum Reform recommendations, the medical school curriculum was reduced from 7 to 6 years. This study aimed to analyze the impact of medical school curriculum reform on medical students' performance in objective structured clinical examinations (OSCEs). MethodsWe retrospectively analyzed the OSCE records at Taipei Veterans General Hospital (Taipei VGH), one of Taiwan's largest tertiary medical centers, between November 2016 and July 2020. The eligibility criteria were medical students receiving a full one-year clinical internship training at Taipei VGH and in their last year of medical school. All medical students received a mock OSCE-1 at the beginning of their internship, a mock OSCE-2 after six months of training, and a national OSCE at the end of their internship. The parameters for performance in OSCEs included “percentage of scores above the qualification standard” and “percentage of qualified stations.” ResultsBetween November 2016 and July 2020, 361 undergraduates underwent clinical internship training at Taipei VGH. Among them, 218 were taught under the 7-year curriculum, and 143 were instructed under the 6-year curriculum. Based on baseline-adjusted ANCOVA results, medical students under the 7-year curriculum had a higher percentage of scores above the qualification standard than those under the 6-year curriculum at the mock OSCE-1 (7-year curriculum vs. 6-year curriculum: 33.8% [95% CI 32.0–35.7] vs. 28.2% [95% CI 25.9–30.4], p<0.001), and mock OSCE-2 (7-year curriculum vs. 6-year curriculum: 89.4% [95% CI 87.4–91.4] vs. 84.0% [95% CI 81.5–86.4], p=0.001). Moreover, medical students in the 7-year curriculum had a higher percentage of qualified stations in mock OSCE-1 (7-year curriculum vs. 6-year curriculum: 89.4% [95% CI 87.4–91.4] vs. 84.0% [95% CI 81.5–86.4], p=0.001) and mock OSCE-2 (7-year curriculum vs. 6-year curriculum: 91.9% [95% CI 90.1–93.8] vs. 86.1% [95% CI 83.8–88.3], p=0.001). After clinical internship training, there were no differences in the percentage of scores above the qualification standard (7-year curriculum vs. 6-year curriculum: 33.5% [95% CI 32.2–34.9] vs. 34.6 [95% CI 32.9–36.3], p=0.328) and percentage of qualified stations (7-year curriculum vs. 6-year curriculum: 89.4% [95% CI 88.1–90.7] vs. 90.2% [95% CI 88.6–91.8], p=0.492). ConclusionsAt the beginning of the internship, medical students under the 7-year curriculum had better OSCE performance than those under the 6-year curriculum. After the clinical internship training in Taipei VGH, there was no difference in the national OSCE score between the 6- and 7-year curricula. Our study suggests that clinical internship is crucial for the development of clinical skills and performance in the national OSCE.

scholarly journals Integrating Simulation Scenarios and Clinical Practices Guided by Concepts of Translational Medicine

2018 ◽  
Vol 7 (1) ◽  
pp. 10
Author(s):  
Jing Yang ◽  
Si-min Huang ◽  
Ze-jian Li ◽  
Lie Feng ◽  
Chun-ting Lu
Keyword(s):  
Internal Medicine ◽  
Medical Students ◽  
Physical Examination ◽  
Clinical Skills ◽  
Case Analysis ◽  
Skills Training ◽  
Observation Group ◽  
Clinical Practices ◽  
Clinical Skills Training ◽  
Significant Difference

Purpose: To develop a novel method for closely and effectively integrating simulation scenarios and clinical practices to improve clinical skills training in the concepts of translational medicine.Methods: Forty-two and 38 third-year medical students in the classes of 2010 and 2009 at Jinan University were selected as an observation group and a control group, respectively. The former group was taught according to a new, integrated mode, while the latter received traditional methods. Students' scores on practical tests in physical examination, internal punctures, and case analysis; theory-based exams on diagnostics and internal medicine; and questionnaire surveys were compared and analyzed. In addition, system-oriented curricula were explored and implemented.Results: A novel mode that closely and effectively integrates theory and practice in the observation group had been established although there were no statistically significant difference (P>0.05) between Grade 2010 and Grade 2009 in clinical basic skills training scores. However, there were statistically significant differences (P<0.05) in scores on practical tests of physical examination and internal punctures among the diagnostic, internal medicine and internship periods in the class of 2010 but no statistically significant difference (P>0.05) in case analysis scores. Therefore, system-oriented curricula were initially designed and explored in excellent students from Grade 2010 to reinforce clinical thinking.Conclusion: The novel program integrating simulation scenarios and clinical situations for training students in diagnostics and internal medicine skills can improve medical students’ clinical comprehensive abilities and achieve effects that are similar to those of the traditional method. This program is more popular with students and ensures patient safety as well. In addition, different characteristics of clinical skills training have been compared for the further exporation of system-oriented curricula. 

scholarly journals Outcomes of Using Heart Sound Simulator in Teaching Cardiac Auscultation

2010 ◽  
Vol 1 (1) ◽  
pp. e46-e50 ◽  
Author(s):  
Ralitsa Akins ◽  
Hoi Ho
Keyword(s):  
Curriculum Reform ◽  
Heart Sound ◽  
Medical Training ◽  
Clinical Skills ◽  
Training Session ◽  
Resident Training ◽  
Training System ◽  
Heart Sounds ◽  
Training Methods ◽  
Significant Difference

Background - Despite continued curriculum reform, the clinical skills competencies of medical graduates at all levels are steadily declining within a training system, where bedside opportunities become a luxury and the laboratory tests prevail over the clinical skills. While high-fidelity expensive simulators are being embraced by high-procedure volume specialties, low-fidelity and relatively inexpensive simulators, such as the heart sounds simulators remain under-utilized in medical training.  Methods - We used a commercially available heart sound synthesizer in 2-hour training sessions with students and residents. Pre-post testing was completed at the beginning of the training session and three weeks after the session; participant responses were recorded by audience interactive response system.  Results - Data analysis was accomplished with statistical software SPSS 17.0 utilizing paired t-test, and showed a statistically significant difference in learners’ knowledge and skills attainment 3 weeks after completion of the simulation training (p<0.0001).  Conclusions - Based on our findings and the review of literature, we recommend that heart sound simulation is introduced at medical student level as the standard for teaching cardiologic auscultation findings and as preparation for auscultation of live patients.  We also suggest that training with digitally simulated heart sounds is similarly beneficial in resident training.

scholarly journals Introduction of structured physical examination skills to second year undergraduate medical students

F1000Research ◽  
2013 ◽  
Vol 2 ◽  
pp. 16 ◽  
Author(s):  
Rano M Piryani ◽  
P Ravi Shankar ◽  
Trilok P Thapa ◽  
Bal M Karki ◽  
Rishi K Kafle ◽  
...  
Keyword(s):  
Physical Examination ◽  
Skill Acquisition ◽  
Clinical Teaching ◽  
Clinical Skills ◽  
Undergraduate Medical Students ◽  
Step Method ◽  
Clinical Skills Assessment ◽  
Learning Techniques ◽  
Second Year ◽  
Teaching Learning

Introduction: Effective learning of physical examination skills (PES) requires suitable teaching and learning techniques and assessment methods. The Tribhuvan University (Nepal) curriculum recommends involving the departments of Medicine and Surgery in PES training (PEST) for second year students as a part of early clinical exposure. The project was developed to make teaching/learning of PES structured, involving eight clinical sciences departments and using appropriate methods for teaching and assessment in KIST Medical College, Nepal.Methods: Irby’s three stages of clinical teaching model (Preparation, Teaching, Reflection), was applied for teaching. Skill acquisition was based on Millers’ learning pyramid at “show how level” and Dreyfus’ competency model at “competent level”. Teaching/learning was conducted in small groups. A tutorial, demonstration and practice (TDS) model was developed for teaching/learning techniques based on a simple five-step method for teaching clinical skills. Assessment of effectiveness of training was done at “reaction level” as per Kirkpatrick’s model based on students’ feedback, “shows how level” as per Miller’s pyramid of learning by OSCE and “competent level” as per Dreyfus’ model using retro-pre questionnaire.Results: The analysis of retro-pre questionnaire based on the Dreyfus model found the average skill score (max score 184), before the introduction of the project module as 15.9 (median = 13.5) and after as 116.5 (median = 116). A paired t-test showed the difference to be statistically significant (100.5±23 and 95% CI 95.45 – 105.59). The average overall feedback score for the students on PES training based on seven items on a five point Likert scale was found to be 4.30. The mean total objective structured clinical examination (OSCE) score was 3.77 (SD+/- 0.33) out of 5; 80% of students scored more than 70%.Conclusion: Students learned most of the skills with the implementation of the structured PES module and did well in the OSCE. Students and faculty were satisfied with the training and assessment.

scholarly journals Assessing the growth in clinical skills using a progress clinical skills examination

PeerJ ◽  
2020 ◽  
Vol 8 ◽  
pp. e9091
Author(s):  
Heather S. Laird-Fick ◽  
Chi Chang ◽  
Ling Wang ◽  
Carol Parker ◽  
Robert Malinowski ◽  
...  
Keyword(s):  
Medical School ◽  
Repeated Measures ◽  
Clinical Skills ◽  
Clinical Skill ◽  
Skills Training ◽  
Longitudinal Growth ◽  
First Year ◽  
Cross Sectional ◽  
First Year Students ◽  
Second Year

Background This study evaluates the generalizability of an eight-station progress clinical skills examination and assesses the growth in performance for six clinical skills domains among first- and second-year medical students over four time points during the academic year. Methods We conducted a generalizability study for longitudinal and cross-sectional comparisons and assessed growth in six clinical skill domains via repeated measures ANOVA over the first and second year of medical school. Results The generalizability of the examination domain scores was low but consistent with previous studies of data gathering and communication skills. Variations in case difficulty across administrations of the examination made it difficult to assess longitudinal growth. It was possible to compare students at different training levels and the interaction of training level and growth. Second-year students outperformed first-year students, but first-year students’ clinical skills performance grew faster than second-year students narrowing the gap in clinical skills over the students’ first year of medical school. Conclusions Case specificity limits the ability to assess longitudinal growth in clinical skills through progress testing. Providing students with early clinical skills training and authentic clinical experiences appears to result in the rapid growth of clinical skills during the first year of medical school.

scholarly journals Empirical analysis comparing the tele-objective structured clinical examination (teleOSCE) and the in-person assessment in Australia

2021 ◽  
Vol 18 ◽  
pp. 23
Author(s):  
Jonathan Zachary Felthun ◽  
Silas Taylor ◽  
Boaz Shulruf ◽  
Digby Wigram Allen
Keyword(s):  
Physical Examination ◽  
Clinical Examination ◽  
Clinical Skills ◽  
Objective Structured Clinical Examination ◽  
High Stakes ◽  
South Wales ◽  
Significant Difference ◽  
Workplace Based Assessment ◽  
The University ◽  
The Impact

Purpose: It aimed to compare the use of the tele objective structured clinical examination (teleOSCE) with in-person assessment in high-stakes clinical examination so as to determine the impact of the teleOSCE on the assessment undertaken. Discussion follows regarding what skills and domains can effectively be assessed in a teleOSCE. Methods: This study is a retrospective observational analysis. It compares the results achieved by final year medical students in their clinical examination, assessed using the teleOSCE in 2020 (n=285), with those who were examined using the traditional in-person format in 2019 (n=280). The study was undertaken at the University of New South Wales, Australia.Results: In the domain of physical examination, students in 2020 scored 0.277 points higher than those in 2019 (mean difference –0.277, P<0.001, effect size 0.332). Across all other domains, there was no significant difference in mean scores between 2019 and 2020.Conclusion: The teleOSCE does not negatively impact assessment in clinical examination in all domains except physical examination. If the teleOSCE is the future of clinical skills examination, assessment of physical examination will require concomitant workplace-based assessment.

Relationship Between Faculty and Standardized Patient Assessment Scores of Podiatric Medical Students During a Standardized Performance Assessment Laboratory

2016 ◽  
Vol 106 (2) ◽  
pp. 116-120 ◽  
Author(s):  
James M. Mahoney ◽  
Vassilios Vardaxis ◽  
Noreen Anwar ◽  
Jacob Hagenbucher
Keyword(s):  
Medical Students ◽  
Physical Examination ◽  
Health Professional ◽  
Faculty Member ◽  
Performance Assessment ◽  
Clinical Skills ◽  
Pearson Correlation ◽  
Faculty Assessment ◽  
Assessment Scores ◽  
Second Year

Background: Direct assessment of health professional student performance of clinical skills can be accurately performed in the standardized performance assessment laboratory (SPAL), typically by health professional faculty. However, owing to time and economic considerations, nonmedical individuals have been specially trained to perform the same function (standardized patients [SPs]). This study compared the assessment scores of the history and physical examination components of a SPAL designed for second-year podiatric medical students at Des Moines University (DMU) by a podiatry medical faculty member and SPs. Methods: A total of 101 students from the classes of 2015 and 2016 were evaluated in 2013 and 2014 by 11 to 13 SPs from the DMU SPAL program. The video recordings of these 101 students were then evaluated by one faculty member from the College of Podiatric Medicine and Surgery at DMU. Results: The Pearson correlation coefficient for each class showed a strong linear relationship between SP and faculty assessment scores. The associations between SP and faculty assessment scores in the history, physical examination, and combined history and physical examination components for the 2016 class (0.706, 0.925, and 0.911, respectively) were found to be stronger than those for the 2015 class (0.697, 0.791, and 0.791, respectively). Conclusions: This study indicated that there are strong associations between the assessment scores of trained SPs and faculty for the history, physical examination, and combined history and physical examination components of second-year SPAL activity for podiatric medical students.

The addition of an upper-extremity curriculum in medical school education and its assessment

2009 ◽  
Vol 34 (6) ◽  
pp. 797-799 ◽  
Author(s):  
C. S DAY ◽  
C. S AHN ◽  
Y. YU
Keyword(s):  
Medical Students ◽  
Medical School ◽  
Upper Extremity ◽  
Curriculum Reform ◽  
School Curriculum ◽  
Medical School Education ◽  
National Examination ◽  
Clinical Confidence ◽  
Second Year ◽  
The Impact

This study assessed the impact of changes made to address the inadequate upper-extremity education through preclinical medical school curriculum reform. After the administration of a new upper-extremity curriculum, which also increased the time devoted to three preclinical medical school courses from 7.25 to 21.25 hours, second-year medical students were evaluated for mastery of these concepts through a national validated objective examination, and attitude and skill through clinical confidence and subjective surveys. After implementation of the new upper-extremity curriculum, students had significantly greater confidence in their ability to perform a physical examination but not in identifying differential diagnoses of the upper-extremity. Students were more satisfied with the amount of time spent on the musculoskeletal system but their performance in the national examination did not change.

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