PRE-CLINICAL SKILLS: A competency-based assessment integrated course implemented early in the curriculum to prepare second-year medical students prior to entering clinical settings

Introduction: The urogenital physical examination is an important aspect of patient encounters in various clinical settings. Introductory clinical skills sessions are intended to provide support and alleviate students’ anxiety when learning this sensitive exam. The techniques each Canadian medical school uses to guide their students through the initial urogenital examination has not been previously reported.Methods: This study surveyed pre-clerkship clinical skills program directors at the main campus of English-speaking Canadian medical schools regarding the curriculum they use to teach the urogenital examination.Results: A response rate of 100% was achieved, providing information on resources and faculty available to students, as well as the manner in which students were evaluated. Surprisingly, over onethird of the Canadian medical schools surveyed failed to provide a setting in which students perform a urogenital examination on a patient in their pre-clinical years. Additionally, there was no formal evaluation of this skill set reported by almost 50% of Canadian medical schools prior to clinical training years.Conclusions: To ensure medical students are confident and accurate in performing a urogenital examination, it is vital they be provided the proper resources, teaching, and training. As we progress towards a competency-based curriculum, it is essential that increased focus be placed on patient encounters in undergraduate training. Further research to quantify students’ exposure to the urogenital examination during clinical years would be of interest. Without this commitment by Canadian medical schools, we are doing a disservice not only to the medical students, but also to our patient population.

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Accuracy of second-year medical students?? self-assessment of clinical skills

Academic Medicine ◽

10.1097/00001888-199710000-00045 ◽

1997 ◽

Vol 72 (10) ◽

pp. S63???5 ◽

Cited By ~ 6

Author(s):

M A Antonelli

Keyword(s):

Medical Students ◽

Clinical Skills ◽

Self Assessment ◽

Second Year

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Can Specialists and Generalists Teach Clinical Skills to Second-year Medical Students with Equal Effectiveness?

Academic Medicine ◽

10.1097/00001888-200210000-00019 ◽

2002 ◽

Vol 77 (10) ◽

pp. 1030-1033 ◽

Cited By ~ 7

Author(s):

Laura J. Zakowski ◽

Christine Seibert ◽

Selma VanEyck ◽

Susan Skochelak ◽

Susan Dottl ◽

...

Keyword(s):

Medical Students ◽

Clinical Skills ◽

Second Year ◽

Equal Effectiveness

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

The Asia Pacific Scholar ◽

10.29060/taps.2021-6-3/sc2394 ◽

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.

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Peers United in Leadership & Skills Enhancement (PULSE): A near peer mentoring program for medical students

Canadian Medical Education Journal ◽

10.36834/cmej.69920 ◽

2020 ◽

Author(s):

Adam Neufeld ◽

Zachary Huschi ◽

Amanda Ames ◽

Greg Malin ◽

Meredith McKague ◽

...

Keyword(s):

Medical Students ◽

Learning Environments ◽

Peer Mentoring ◽

Clinical Skills ◽

Leadership Skills ◽

Skills Development ◽

Structured Learning ◽

First Year ◽

Mentoring Program ◽

Second Year

Implication Statement We created a near peer mentoring program in pre-clerkship, which gave medical students the opportunity to work together, teach others, and practice their clinical skills. It uniquely connects first year “learner-mentees” and second year “instructor-mentors” in semi-structured learning environments, from October to April. Beyond supporting intrinsic motivation, skills development, and collaboration, students gained experience in teaching; an important skill for physicians.

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Hands in medicine: understanding the impact of competency-based education on the formation of medical students’ identities in the United States

Journal of Educational Evaluation for Health Professions ◽

10.3352/jeehp.2016.13.31 ◽

2016 ◽

Vol 13 ◽

pp. 31 ◽

Cited By ~ 5

Author(s):

Catherine Gonsalves ◽

Zareen Zaidi

Keyword(s):

United States ◽

Medical Students ◽

Identity Formation ◽

Social Role ◽

Clinical Skills ◽

Core Competencies ◽

The United States ◽

Competency Based Education ◽

Competency Based ◽

The Impact

Purpose: There have been critiques that competency training, which defines the roles of a physician by simple, discrete tasks or measurable competencies, can cause students to compartmentalize and focus mainly on being assessed without understanding how the interconnected competencies help shape their role as future physicians. Losing the meaning and interaction of competencies can result in a focus on ‘doing the work of a physician’ rather than identity formation and ‘being a physician.’ This study aims to understand how competency-based education impacts the development of a medical student’s identity. Methods: Three ceramic models representing three core competencies ‘medical knowledge,’ ‘patient care,’ and ‘professionalism’ were used as sensitizing objects, while medical students reflected on the impact of competency-based education on identity formation. Qualitative analysis was used to identify common themes. Results: Students across all four years of medical school related to the ‘professionalism’ competency domain (50%). They reflected that ‘being an empathetic physician’ was the most important competency. Overall, students agreed that competency-based education played a significant role in the formation of their identity. Some students reflected on having difficulty in visualizing the interconnectedness between competencies, while others did not. Students reported that the assessment structure deemphasized ‘professionalism’ as a competency. Conclusion: Students perceive ‘professionalism’ as a competency that impacts their identity formation in the social role of ‘being a doctor,’ albeit a competency they are less likely to be assessed on. High-stakes exams, including the United States Medical Licensing Exam clinical skills exam, promote this perception.

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Pre-clinical remote undergraduate medical education during the COVID-19 pandemic: a survey study

BMC Medical Education ◽

10.1186/s12909-020-02445-2 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Bita Shahrvini ◽

Sally L. Baxter ◽

Charles S. Coffey ◽

Bridget V. MacDonald ◽

Lina Lander

Keyword(s):

Medical Students ◽

Clinical Skills ◽

The United States ◽

Living Environment ◽

Learning Material ◽

Quality Of Instruction ◽

Skills Laboratory ◽

Second Year ◽

Remote Learning

Abstract Background The Coronavirus Disease 2019 (COVID-19) pandemic has necessitated a sudden transition to remote learning in medical schools. We aimed to assess perceptions of remote learning among pre-clinical medical students and subsequently to identify pros and cons of remote learning, as well as uncover gaps to address in ongoing curricular development. Methods A survey was distributed to first- and second-year medical students at the University of California San Diego School of Medicine in March 2020. Frequencies of responses to structured multiple-choice questions were compared regarding impacts of remote learning on quality of instruction and ability to participate, value of various remote learning resources, living environment, and preparedness for subsequent stages of training. Responses to open-ended questions about strengths and weaknesses of the remote curriculum and overall reflections were coded for thematic content. Results Of 268 students enrolled, 104 responded (53.7% of first-year students and 23.9% of second-year students). Overall, students felt that remote learning had negatively affected the quality of instruction and their ability to participate. Most (64.1%) preferred the flexibility of learning material at their own pace. Only 25.5% of respondents still felt connected to the medical school or classmates, and feelings of anxiety and isolation were noted negatives of remote learning. Most second-year students (56.7%) felt their preparation for the United States Medical Licensing Examination Step 1 exam was negatively affected, and 43.3% felt unprepared to begin clerkships. In narrative responses, most students appreciated the increased flexibility of remote learning, but they also identified several deficits that still need to be addressed, including digital fatigue, decreased ability to participate, and lack of clinical skills, laboratory, and hands-on learning. Conclusions Videocasted lectures uploaded in advance, electronic health record and telehealth training for students, and training for teaching faculty to increase technological fluency may be considered to optimize remote learning curricula.

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MP16: Oral case presentation: evaluation of a novel curriculum and development of a competency-based assessment tool in Emergency Medicine

CJEM ◽

10.1017/cem.2020.164 ◽

2020 ◽

Vol 22 (S1) ◽

pp. S48-S48

Author(s):

T. Wawrykow ◽

T. McColl ◽

A. Velji ◽

M. Chan

Keyword(s):

Emergency Medicine ◽

Medical Students ◽

Blended Learning ◽

Assessment Tool ◽

Intervention Group ◽

Emergency Setting ◽

Case Presentation ◽

Canadian Association ◽

Competency Based ◽

Competency Based Assessment

Introduction: The oral case presentation is recognized as a core educational and patient care activity but has not been well studied in the emergency setting. The objectives of this study are: 1) to develop a competency-based assessment tool to formally evaluate the emergency medicine oral case presentation (EM-OCP) competency of medical students and ‘transition to discipline’ residents, and 2) to develop, implement and evaluate a curriculum to enhance oral case presentation (OCP) communication skills in the emergency medicine (EM) setting. Methods: Using data from a literature review, a Canadian Association of Emergency Physicians national survey, and local focus groups, the authors designed an OCP framework, blended learning curriculum, and EM-OCP assessment tool. Ninety-six clerkship students were randomly assigned to receive either the control, the standard clerkship curriculum, or intervention, the blended learning curriculum. At the beginning of their emergency medicine rotation, learners completed a pre-test using a standardized patient (SP) case to assess their baseline OCP skills. The intervention group then completed the EM-OCP curriculum. All students completed post-tests with a different SP at the end of the six-week EM rotation. Audio-recordings of pre and post-tests were evaluated using the assessment tool by two blinded evaluators. Results: Using the Kruskal-Wallis test, all students demonstrated improvement in EM-OCP skills between their pre-test and post-test, however, those who received the blended learning curriculum showed significantly greater improvement in synthesis of information (p = 0.044), management (p = 0.006) and overall entrustment decision score (p = 0.000). Conclusion: Implementation of a novel EM-OCP curriculum resulted in more effective communication and higher entrustment scores. This curriculum could improve OCP performance not only in emergency medicine settings but also across specialties where medical students and residents must manage critical patients.

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An educational interventional study to compare conventional versus peyton’s method in training medical students on antenatal examination skills

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20205768 ◽

2020 ◽

Vol 10 (1) ◽

pp. 198

Author(s):

Dhivya Sethuraman ◽

S. Revwathy ◽

Prabha Thangaraj

Keyword(s):

Medical Students ◽

Conventional Method ◽

Clinical Skills ◽

Core Competency ◽

Training Technique ◽

Education In India ◽

Competency Based ◽

The Difference ◽

Uniform Manner ◽

Group B

Background: Introduction of competency based medical education in India has made it imperative to teach and assess clinical skills in a uniform manner. Antenatal Examination is one of the core competency under Obstetrics and Gynaecology. We need to use effective instructional methods to teach skills. In this study, we have compared Peyton’s ‘four step approach’ with the conventional ‘see one, do one’ approach.Methods: A quasi- randomized crossover study with educational intervention was done among 49 medical students. They were divided into two groups (A and B). Students of group A were first trained on Antenatal examination using Conventional method and evaluated. With a gap of one week, they were re-trained on the same skill using Peyton’s method and re-evaluated again; the vice versa was for done in group B. Mann Whitney test was used to compare the difference in score between the two groups of students (A and B) and Wilcoxon Signed Ranks test was used to compare the student’s perception of both teaching methods.Results: The mean score obtained by students after the first training by Peyton’s (24.08±2.31) was greater than Conventional method (20.32±3.59) which was found to be statistically significant (Z=-3.54, p<0.5). Following the second training i.e crossover of the training technique, the marks obtained by both group of students were almost the same. Students perceived Peyton’s methods to be more interesting, interactive, better understanding and recall over conventional.Conclusions: Peyton’s method was found to be superior over conventional method of training medical students in Antenatal examination.

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Developing A Validated Instrument To Assess Paediatric Interns In South Africa

10.21203/rs.2.22362/v1 ◽

2020 ◽

Author(s):

Kimesh Naidoo ◽

Jacqueline M Van Wyk

Keyword(s):

Factor Analysis ◽

Assessment Tool ◽

Clinical Skills ◽

Core Competencies ◽

Methodological Approach ◽

Assessment Process ◽

Emotional Skills ◽

Daunting Task ◽

Competency Based ◽

Competency Based Assessment

Abstract Background: Recently graduated South African medical practitioners (interns) are expected to be efficient and resilient in limited resource contexts that face multiple disease burdens. Work-based assessment in SA internship focuses on clinical skills and neglects the evaluation of non-clinical skills. This sub-optimal assessment process creates a daunting task for clinician supervisors who are expected to certify these interns for independent practice. Methods: Using a mixed methodological approach, the study sampled a cross section of 411 interns in seven hospitals in KwaZulu-Natal and their intern supervisors . Data collection methods included focus groups discussions and surveys. A 4-round modified Delphi-process was followed to reach consensus on the set of core competencies required. The assessment tool that resulted in the process included a variety of competencies and the tool was validated through factor analysis and internal consistency was measured with Cronbach’s alpha. Results : A competency-based assessment tool was developed that allows for the assessment of both clinical and non-clinical skills. This tool was found to be very reliable, with an overall Cronbach alpha of 0.927. Factor analysis for the instrument revealed 61 observable clinical activities aggregated into entrustable professional activities and these measured four major factors. The factors correspond with procedural clinical skills; holistic-care skills; and emotional skills related to social competence and self-management. Conclusion: A locally relevant competency-based assessment tool was developed in SA to assess local paediatric interns. The validated tool’s function as a multidimensional instrument to assess both clinical and non-clinical skills included the assessment of emotional skills which are largely neglected. Validated work-based assessment instruments can be developed that are responsive to local needs and support the development of holistic clinicians in high disease-burdened contexts.

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