scholarly journals Using peer role-playing to improve students’ clinical skills for musculoskeletal physical examinations

2020 ◽  
Author(s):  
Kazuyo Yamauchi ◽  
Yoko Hagiwara ◽  
Nahoko Iwakura ◽  
Saori Kubo ◽  
Azusa Sato ◽  
...  

Abstract Background: The traditional curriculum for medical students in Japan does not include sufficient opportunity for the students to develop their skills for musculoskeletal (MSK) examination and clinical reasoning and diagnosis. So, the effective program requires to help medical students and residents improve these clinical skills about MSK. Our purpose was to assess using mini-CEX that these clinical skills of medical students have experienced peer role-playing simulation program.Methods: Participants were 90 women medical students who were completing their first orthopaedic clinical clerkship, were allocated into two groups. The simulation group encountered with role-play for MSK cases as low fidelity simulation, and a structured debriefing with the course supervisor including self- reflection at Day 1 (n = 64). The control group did not participate in the role-play due to clerkship schedule randomized (n = 26). We observed and assessed all participants’ performance at outpatient encounter using the mini clinical evaluation exercise (mini-CEX) when all participant encountered the first visit MSK outpatient at Day 2, and compared mini-CEX score between the simulation group and the control group. A statistical method was used Wilcoxon rank-sum test.Results: The Physical examination, the Clinical reasoning and Diagnosis, and the Overall clinical competency of the mini-CEX scores were significant differences in the simulation group higher than in the control group (p < .05, Physical examination: p = .014, Clinical Reasoning: p = .042, Overall: p = .016). These finding suggests the possibility that our medical students who have experienced peer role-playing simulation program improved the clinical skills of physical examination, the clinical reasoning and diagnosis, and the Overall clinical competency on the real-life MSK outpatient encounters.Conclusions: We successfully capture to assess using mini-CEX that these clinical skills improving of medical students who have experienced peer role-playing simulation program. A peer role-playing as a low-fidelity simulation will enable to polish the competency of medical students a musculoskeletal physical examination, and a clinical reasoning and diagnosis in a clinical setting, as a practical educational opportunity.

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kazuyo Yamauchi ◽  
Yoko Hagiwara ◽  
Nahoko Iwakura ◽  
Saori Kubo ◽  
Azusa Sato ◽  
...  

Abstract Background The traditional curriculum for medical students in Japan does not include sufficient opportunities for students to develop their skills for musculoskeletal (MSK) examination and clinical reasoning and diagnosis. Therefore, an effective programme is required to help medical students and residents improve their clinical skills in MSK. This paper aims to assess the clinical skills of medical students who have participated in a peer role-playing simulation programme using a mini clinical evaluation exercise (mini-CEX). Methods Participants were 90 female medical students who were completing their first orthopaedic clinical clerkship. They were divided into two groups. The simulation group participated in a role-play focussed on MSK cases as low-fidelity simulation, a structured debriefing with the course supervisor, and a self-reflection on Day 1 (n = 64). The control group did not participate in the role-play due to randomised clerkship schedules (n = 26). On Day 2 of the intervention, we observed and assessed all participants’ performances during MSK outpatient encounters using the mini-CEX. We compared the mini-CEX score between the simulation group and the control group; the Wilcoxon rank-sum test was used for statistical analysis. Results The mini-CEX scores for physical examination, clinical reasoning and diagnosis, and overall clinical competency were significantly higher in the simulation group than in the control group (p < .05, physical examination: p = .014, clinical reasoning: p = .042, overall: p = .016). These findings suggest that medical students who partake in a peer role-playing simulation programme could experience improved clinical skills for physical examination, clinical reasoning and diagnosis, and overall clinical competency in real-life MSK outpatient encounters. Conclusions Through a mini-CEX assessment, our findings indicate that medical students who participated in our peer role-playing simulation programme have improved clinical skills. Peer role-playing as a low-fidelity simulation and practical educational opportunity will enable educators to polish the competency of medical students in musculoskeletal physical examinations and clinical reasoning and diagnosis in a clinical setting.


2020 ◽  
Author(s):  
Kazuyo Yamauchi ◽  
Yoko Hagiwara ◽  
Nahoko Iwakura ◽  
Saori Kubo ◽  
Azusa Sato ◽  
...  

Abstract The traditional curriculum for medical students in Japan does not include sufficient opportunity for the students to develop their skills for musculoskeletal examination and clinical reasoning and diagnosis. So, many residents report a lack of confidence in performing these tasks. Our aim was to assess the effectiveness of peer role-playing to improving these skills among 90 women medical students who were completing their first orthopaedic clinical clerkship. Participants were allocated into two groups. One group participated in role-play (the simulation group) and the other did not participate in role-play because of the clerkship schedule or almanac circumstance (the no-simulation group). This program consisted of two modules: the simulation-based module and the outpatient encounter module. Each module included two sessions. The simulation-based module had two parts: a structured encounter with role-play for musculoskeletal cases, and a structured debriefing with the course supervisor including self-reflection. The students’ performance was observed and assessed using the mini clinical evaluation exercise (mini-CEX) for musculoskeletal cases in the simulation-based module (Day1) and the outpatient encounter module (Day2). The simulation-based module increased the physical examination score on the mini-CEX because of the encounters with real-life patients with musculoskeletal symptoms. This result suggests that role-play as a peer enhancing simulation may help to improve the competency of medical students in performing a musculoskeletal physical examination in a clinical setting.


2019 ◽  
Vol 47 (11) ◽  
pp. 5526-5535 ◽  
Author(s):  
Liling Chen ◽  
Hong Chen ◽  
Di Xu ◽  
Yan Yang ◽  
Huiming Li ◽  
...  

Objective The study objective was to enhance clinical skills among undergraduate students majoring in clinical medicine in performing physical examination by establishing a novel platform for peer assessment of clinical skills. Methods A total 126 Year 2012 students majoring in medicine and receiving traditional training were assigned to the control group, and 126 Year 2013 students receiving instruction via the peer assessment platform of clinical skills were allocated to the study group. Scores of the physical examination, paper exam, and peer assessment were compared using a t-test, and we performed linear correlation analysis of the data. Results Scores of the physical examination and peer assessment among Year 2013 students (the study group) were significantly higher than those in the control group. Paper exam scores in the study group were also significantly higher than those in the controls. The three assessment scores did not differ significantly according to sex. Conclusions The peer assessment platform can not only improve medical students’ skills and capabilities in physical examination, it can also enhance their theoretical knowledge of basic clinical principles. We determined that sex was not related to the assessment scores obtained by medical students.


2020 ◽  
Author(s):  
Nadia YOUNES ◽  
Anne Laure Delaunay ◽  
Matthieu Roger ◽  
Pierre Serra ◽  
France Hirot ◽  
...  

Abstract Background: Training in psychiatry requires specific knowledge, attitudes, and skills that are obtainable by simulation, which needs further development for medical students. After an analysis of previous research with medical students, we evaluated the effectiveness of a one-day teaching program in psychiatry by simulation and validated a scale measuring Confidence in Psychiatric Clinical Skills (CPCQ). Methods: The population was recruited during the 2019-2020 academic year among the 131 fifth-year undergraduate students at the French University of Versailles Saint-Quentin-en-Yvelines-Paris Saclay (the year of compulsory psychiatric training). A controlled study compared knowledge (university grades on the entire national program of psychiatry) and confidence (CPCQ scores) between a control group who received the usual psychiatric instruction and the simulation group who also participated in the simulation program. In the simulation group, satisfaction (including the quality of the debriefing) was investigated. The CPCQ scale was validated by assessing the factor structure, internal consistency, and test-retest reliability.Results: All fifth-year undergraduate medical students were included: 24 in the simulation group (voluntarily recruited) and 76 in the control group. Their knowledge did not differ before the simulation. After the simulation, knowledge and confidence increased significantly in the simulation group. Two months after the simulation, knowledge and confidence were significantly higher in the simulation group. Satisfaction with the training and debriefing was very high. The CPCQ scale showed good psychometric properties: a single-factor structure, acceptable internal consistency (α=0.73 [0.65 - 0.85]), and good test-retest reliability (ICC=0.71 [0.35 - 0.88]).Several limits were discussed.Conclusions: Adding a one-day simulation program in psychiatry to the usual teaching improved the knowledge and confidence of medical students even 2 months after. The CPCQ scale could be used for the evaluation of educational programs.


Objectives: Virtual patient simulation (VPS) is used in the education of health care professionals. This method brings an opportunity for the learner to examine necessary diagnostic and therapeutic skills. The aim of this study was to assess the efficacy of VPS on clinical reasoning abilities of medical students and to evaluate their attitude towards VPS in clinical endocrinology course in a teacher centered educational environment. Methods: Fifty-one medical students in their 6th academic year were simply randomized in two groups, the simulation and the control. The students in the simulation group were provided by an application which presented them virtual case scenarios on diagnosis and management of thyroid nodules and osteomalacia. All the students sat for a diagnostic test at the beginning and at the end of the course. The test comprised a series of essay questions matched for their academic level and closely related to the case scenarios. They were also asked to complete a questionnaire to assess their attitude towards the application. Results: Participants in both groups did not have any statistical differences in scientific background in basic sciences (P=0.672) and prior clinical examinations (P=0.376). At completion of the course the mean score of the students in the simulation group improved significantly compared to the students in the control group by 3.5 vs. 1.0 points (P=0.001). The students found the application worthful and showed a positive attitude towards it. Conclusions: Virtual patient simulation improved clinical reasoning abilities of medical students in the context of a traditional teaching/learning environment.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Nadia Younes ◽  
Anne Laure Delaunay ◽  
M. Roger ◽  
Pierre Serra ◽  
France Hirot ◽  
...  

Abstract Background Training in psychiatry requires specific knowledge, attitudes, and skills that are obtainable by simulation, of which the use is only recent and still needs further development. Evidence is accumulating on its effectiveness but requires further validation for medical students. We aimed to evaluate the effectiveness of a single-day optional teaching program in psychiatry by simulation for medical students and validate a scale measuring Confidence in Psychiatric Clinical Skills (CPCQ), as part of the assessment. Methods This was a controlled study in a French University that compared (using paired-sample Student t-tests) knowledge and attitudes (university grades and CPCQ scores) before, just after teaching with simulated patients, and 2 months later. Satisfaction with the program (including the quality of the debriefing) was also investigated. The CPCQ scale was validated by assessing the factor structure, internal consistency, and test-retest reliability. Finally, a comparison was run with a control group who received the usual psychiatric instruction using covariance analyses. Results Twenty-four medical students were included in the simulation group and 76 in the control group. Just after the simulation, knowledge and attitudes increased significantly in the simulation group. Satisfaction with the training and debriefing was very high. The CPCQ scale showed good psychometric properties: a single-factor structure, acceptable internal consistency (α = 0.73 [0.65–0.85]), and good test-retest reliability (ICC = 0.71 [0.35–0.88]). Two months after the simulation, knowledge and attitudes were significantly higher in the simulation group than the control group, despite a lack of difference in knowledge before the simulation. Conclusions Adding a simulation program in psychiatry to the usual teaching improved the knowledge and confidence of medical students. The CPCQ scale could be used for the evaluation of educational programs.


2018 ◽  
Vol 10 (2) ◽  
pp. 58-71
Author(s):  
Solehudin Solehudin

Handwashing with soap one of the Clean and Healthy Behavior. PHBS is also conducted in schools based on KMK No. 1429 / MENKES / SK / XII / 2006, and became one of the duties of the nurse as an extension worker. The success of counseling with the selection of appropriate methods. The methods used in SMP N 1 Gunung Putri are lecture methods, group discussions, and role play methods. Known data of sick students in 2015/2016, 143 times tifoid become first sequence with incidence 60 times (42%), ISPA 30 times (21%) and skin disease 20 times (14%). By hand washing is expected to reduce disease and can improve student health status. This study analyzes the influence of the use of role play method on hand washing properly viewed from the knowledge of students of class VII SMP N 1 Gunung Putri Bogor in 2016. This type of research is quantitative, quasi experimental design with nonequivalent control group design. By probability sampling technique, that is cluster random sampling. Respondents 50 (25 experiments and 25 controls). Data were obtained through pre and post test with questionnaire and hand washing practice. Statistical analysis used independent t-test, paired t-test, ANNOVA followed by post hoc scheffe. Independent t-test result result is sig.0.610 which means there is no difference between the two classes (equivalent). The result of paired t-test result is sig value in both classes <0.05 which means there is influence of knowledge. The result of post hoc scheffe on the correct knowledge and hand washing produced interaction by looking at significance and mean value ie A2B1 with sig. 0.31 and A2B2 with sig. 0.14 which are both role play classes. Mean A2B2 75.00 which means there is interaction influence so it can be concluded that Ha accepted that there is interaction influence the use of role play method on hand washing is correct in terms of student knowledge. This research is expected to contribute in providing reference in choosing the right method. As well as to wash the right hands become a habit and entrust to the respondents in order to improve the degree of health.


2021 ◽  
Vol 10 (4) ◽  
pp. 124
Author(s):  
Nooreen Noordin ◽  
Laleh Khojasteh

This study was designed to see whether electronic feedback positively affects medical students’ academic writing performance. Two groups of medical university students were randomly selected and participated in this study. In order to see whether the provision of electronic feedback for the compulsory academic writing course for medical students is effective, the researchers divided 50 medical students to the traditional (n=25) and intervention groups (n=25). Pre-test and post-test were conducted at the beginning and at the end of the semester. Electronic feedback was given to the medical students in the intervention group, while the medical students in the traditional group received the traditional pen and paper feedback. By comparing the scores of two written assignments at the beginning and the end of the semester, regarding the application of electronic feedback, the results showed that not only medical students’ overall writing performance improved after providing them electronic feedback, but every single writing component was also enhanced after the intervention. There was a significant difference in the post-test academic writing scores between the traditional and intervention groups (P < 0.001). This difference was not significant in our control group who was given pen-and-paper feedback. In terms of specific writing components, the most affected components in this approach were content followed by organization, language use, vocabulary, and sentence mechanics, respectively. Although this study focused on medical students’ academic writing ability and reported the effect of electronic feedback on medical students’ writing performance, electronic feedback can be equally beneficial for enhancing student-practitioners’ practical clinical skills.


Healthcare ◽  
2021 ◽  
Vol 9 (3) ◽  
pp. 243
Author(s):  
Yon Hee Seo ◽  
Mi Ran Eom

The purpose of this study was to assess the effect of a simulation nursing education program in terms of clinical reasoning, problem-solving process, self-efficacy, and clinical competency using the Outcome-Present State-Test (OPT) model in nursing students. The participants comprised 45 undergraduate nursing students recruited from two universities in Korea. The number of nursing students assigned to the experimental group and control group were 25 and 20, respectively. For a period of two weeks, the experimental group received a simulation nursing education program using the OPT model, while the control group received a traditional clinical practicum. The data were analyzed using prior homogeneity tests (Fisher’s exact test and paired t-test); ANCOVA was performed to investigate the differences in dependent variables between the two groups. There was a significant improvement in clinical reasoning (F = 10.59, p = 0.002), problem-solving process (F = 30.92, p < 0.001), and self-efficacy (F = 36.03, p < 0.001) in the experimental group as compared to the control group (F = 10.59, p = 0.002). Moreover, the experimental group showed significantly higher scores in clinical competency than the control group (F = 11.07, p = 0.002). This study demonstrates that the simulation nursing education program using the OPT model for undergraduate students is very effective in promoting clinical reasoning, problem-solving processes, self-efficacy, and clinical competency.


Healthcare ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. 500
Author(s):  
Yu-Ting Hsiao ◽  
Hsuan-Yin Liu ◽  
Chih-Cheng Hsiao

Clinical competencies consisting of skills, knowledge, and communication techniques should be acquired by all medical graduates to optimize healthcare quality. However, transitioning from observation to hands-on learning in clinical competencies poses a challenge to medical students. The aim of this study is to evaluate the impact of a novel interactive multimedia eBook curriculum in clinical competency training. Ninety-six medical students were recruited. Students in the control group (n = 46) were taught clinical competencies via conventional teaching, while students in the experimental group (n = 50) were taught with conventional teaching plus interactive multimedia eBooks. The outcomes of clinical competencies were evaluated using Objective Structured Clinical Examination (OSCE) scores, and feedback on their interactive eBook experiences was obtained. In the experimental group, the average National OSCE scores were not only higher than the control group (214.8 vs. 206.5, p < 0.001), but also showed a quicker improvement when comparing between three consecutive mock OSCEs (p < 0.001). In response to open-ended questions, participants emphasized the importance of eBooks in improving their abilities and self-confidence when dealing with ‘difficult’ patients. Implementing interactive multimedia eBooks could prompt a more rapid improvement in clinical skill performance to provide safer healthcare, indicating the potential of our innovative module in enhancing clinical competencies.


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