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