scholarly journals Achieving physical examination competence through optimizing hands-on practice cycles: a prospective cohort comparative study of medical students

PeerJ ◽  
2021 ◽  
Vol 9 ◽  
pp. e12544
Author(s):  
Zinan Zhang ◽  
Zhenwei Tang ◽  
Fang Wang ◽  
Jingjia Yu ◽  
Youzhou Tang ◽  
...  
Keyword(s):  
Medical Students ◽  
Physical Examination ◽  
Comparative Study ◽  
High Frequency ◽  
Clinical Skill ◽  
Skills Training ◽  
Optimal Number ◽  
Learning Curves ◽  
Final Exam ◽  
Hands On

Background Deliberate practice (DP) was proposed for effective clinical skill training, which highlights focused, repetitive practice and feedback as the key points for practice. Although previous studies have investigated the effect of feedback in DP, little is known about the proper repetitive cycles of clinical skills training especially in physical examination (PE) training. Methods We drew learning curves and designed a comparative study to find out the optimal number of hands-on practice cycles, an important aspect of DP, in abdominal PE training for medical students. A comparative study was conducted to validate the optimal number of hands-on practice by dividing students into two cohorts including Cohort A (high-frequency hand-on training) and B (low-frequency hand-on training). Results The learning curve study of 16 students exhibited a threshold of four repetitive practices when 81.25% students reached the competence score. A total of 74 students’ final exam scores were collected for analysis. Students in Cohort A (4–5 PEs) scored significantly higher than those in Cohort B (≤3 PEs) (84.41 ± 11.78 vs 76.83 ± 17.51] in the final exam (P = 0.030)). Conclusion High-frequency practice can improve students’ competence of abdominal PE skill. We recommend four cycles of hands-on practice for each student in a training course like PE training.

scholarly journals Effects of a new parallel primary healthcare centre and on-campus training programme on history taking, physical examination skills and medical students' preparedness: a prospective comparative study in Taiwan

BMJ Open ◽  
2017 ◽  
Vol 7 (9) ◽  
pp. e016294 ◽  
Author(s):  
Ying-Ying Yang ◽  
Shuu-Jiun Wang ◽  
Ling-Yu Yang ◽  
Jiing-Feng Lirng ◽  
Chia-Chang Huang ◽  
...  
Keyword(s):  
Medical Students ◽  
Physical Examination ◽  
Comparative Study ◽  
Positive Association ◽  
Skills Training ◽  
Training Programme ◽  
Patient Contact ◽  
History Taking ◽  
Hospital Practice ◽  
Academic Year

ObjectivesThe primary healthcarecentre (PHCC) is the first place that medical students experience patient contact. Usually, medical students are frustrated by a lack of proper skills training for on-campus history taking (HT), physical examination (PE) and self-directed learning (SDL) to prepare for their PHCC and inhospital patient contact. For pre-clerks, this study aims to compare the effectiveness of PHCC training and PHCC training in combination with on-campus HT and PE training modules (PHCC+on-campus) on their clerkship preparedness.DesignThis comparative study utilised prospective, consecutive, end of pre-clerkship group objective structured clinical examination (GOSCE), beginning of clerkship OSCE and self-administered Preparation for Hospital Practice Questionnaire (PHPQ).Setting/participants128 pre-clinical clerk volunteers (64 each year) receiving PHCC training (7 week PHCCtraining in addition to 7 week assignment based group learning, academic year 2014, controls) and PHCC training in combination with on-campus module training (academic year 2015, 7 week PHCCtraining in addition to 7 week on-campus sessions) were sequentially assessed before the module (week 1), at the end of the module (week 14) and at the beginning of clerkship (week 25).ResultsFor overall HT and PE skills, both PHCC and PHCC+on-campus module trained pre-clerks performed better on OSCE than GOSCE. Additionally, the improvement was accompanied by higher self-reported PHPQ scores in ‘confidence/coping’ and ‘SDL’ domains. At the end of the pre-clerkship and the beginning of the clerkship stages, the degree of improvement in preparedness in ‘confidence/coping’ and ‘SDL’ domains was higher for those in the PHCC+on-campus group than for those in the PHCC group. Among the PHCC+on-campus module participants, a positive association was observed between high mean PHPQ-SDL scores and high OSCE scores.ConclusionsOur study suggests that the PHCC+on-campus module, which is paired faculty led and pre-trained dyad student assisted, is effective in developing a preclinical clerk’s HT and PE skills and intensifying SDL/patient management abilities to prepare for hospital practice in clerkship.

scholarly journals Comparison of the effects of simulated patient clinical skill training and student roleplay on objective structured clinical examination performance among medical students in Australia

2019 ◽  
Vol 16 ◽  
pp. 3 ◽  
Author(s):  
Silas Taylor ◽  
Matthew Haywood ◽  
Boaz Shulruf
Keyword(s):  
Medical Students ◽  
Physical Examination ◽  
Communication Skills ◽  
Skill Training ◽  
Clinical Skill ◽  
Skills Training ◽  
Performance Outcomes ◽  
Simulated Patient ◽  
Procedural Skills ◽  
Clinical Communication

Purpose: Optimal methods for communication skills training (CST) are an active research area, but the effects of CST on communication performance in objective structured clinical examinations (OSCEs) has not been closely studied. Student roleplay (RP) for CST is common, although volunteer simulated patient (SP) CST is cost-effective and provides authentic interactions. We assessed whether our volunteer SP CST program improved OSCE performance compared to our previous RP strategy. Methods: We performed a retrospective, quasi-experimental study of 2 second-year medical student cohorts’ OSCE data in Australia. The 2014 cohort received RP-only CST (N=182) while the 2016 cohort received SP-only CST (N=148). The t-test and analysis of variance were used to compare the total scores in 3 assessment domains: generic communication, clinical communication, and physical examination/procedural skills. Results: The baseline characteristics of groups (scores on the Australian Tertiary Admission Rank, Undergraduate Medicine and Health Sciences Admission Test, and medicine program interviews) showed no significant differences between groups. For each domain, the SP-only CST group demonstrated superior OSCE outcomes, and the difference between cohorts was significant (P<0.01). The superiority of volunteer SP CST over student RP CST in terms of OSCE performance outcomes was found for generic communication, clinical communication, and physical examination/procedural skills. Conclusion: The better performance of the SP cohort in physical examination/procedural skills might be explained by the requirement for patient compliance and cooperation, facilitated by good generic communication skills. We recommend a volunteer SP program as an effective and efficient way to improve CST among junior medical students.

scholarly journals Collaborative testing in physical examination skills training and the autonomous motivation of students: a qualitative study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jiska A. Patiwael ◽  
Anje H. Douma ◽  
Natalia Bezakova ◽  
Rashmi A. Kusurkar ◽  
Hester E. M. Daelmans
Keyword(s):  
Medical Students ◽  
Physical Examination ◽  
Training Session ◽  
Autonomous Motivation ◽  
Skills Training ◽  
Psychological Needs ◽  
Active Participation ◽  
Basic Psychological Needs ◽  
Collaborative Testing ◽  
Traditional Format

Abstract Background Teaching methods that stimulate the active learning of students make a positive impact on several aspects of learning in higher education. Collaborative testing blended with teaching is one such method. At our medical school, a training session was designed using a collaborative testing format to engage medical students actively in the theoretical phase of a physical examination training, and this session was evaluated positively by our students. Therefore, we extended the use of the format and converted more of the training into collaborative testing sessions. The literature on collaborative testing and the theoretical framework underlying its motivational mechanisms is scarce; however, students have reported greater motivation. The aim of the current study was to investigate student perceptions of a collaborative testing format versus a traditional teaching format and their effects on student motivation. Methods Year four medical students attended seven physical examination training sessions, of which three followed a collaborative testing format and four a traditional format. The students were asked to evaluate both formats through questionnaires comprised of two items that were answered on a five-point Likert scale and five open-ended essay questions. Content analysis was conducted on the qualitative data. The themes from this analysis were finalized through the consensus of the full research team. Results The quantitative data showed that 59 students (55%) preferred collaborative testing (agreed or strongly agreed), 40 students (37%) were neutral, and 8 students (8%) did not prefer collaborative testing (disagreed or strongly disagreed). The themes found for the collaborative testing format were: ‘interaction’, ‘thinking for themselves’, and ‘active participation’. ‘Interaction’ and ‘thinking for themselves’ were mainly evaluated positively by the students. The most frequently mentioned theme for the traditional format was: ‘the teacher explaining’. Students evaluated this theme both positively and negatively. Conclusions The most frequently mentioned themes for the collaborative testing format, namely ‘interaction’, ‘thinking for themselves’, and ‘active participation’, fit within the framework of self-determination theory (SDT). Therefore, the collaborative testing format may support the fulfilment of the three basic psychological needs indicated in SDT: autonomy, competence, and relatedness. Thus, our findings provide initial support for the idea that the use of collaborative testing in medical education can foster the autonomous motivation of students.

scholarly journals MP16: Which PoCUS skills are retained over time for medical students?

CJEM ◽  
2019 ◽  
Vol 21 (S1) ◽  
pp. S47-S48
Author(s):  
L. Edgar ◽  
L. Fraccaro ◽  
L. Park ◽  
J. MacIsaac ◽  
P. Pageau ◽  
...  
Keyword(s):  
Medical Students ◽  
Procedural Knowledge ◽  
Point Of Care ◽  
Skills Training ◽  
Multiple Choice Questions ◽  
Skills Retention ◽  
Hands On ◽  
Second Year ◽  
Point Of Care Ultrasonography ◽  
Over Time

Introduction: Point-of-care ultrasonography (PoCUS) is being incorporated into Canadian undergraduate medical school curricula. The purpose of this study was to evaluate novel PoCUS education sessions to determine what aspects of the sessions benefitted from hands-on training and which PoCUS skills were retained over time. Methods: Second year medical students voluntarily received three different PoCUS training sessions, each lasting three hours. Prior to the sessions, participants prepared independently with pre-circulated online learning materials. After a 15-minute lecture, experienced PoCUS providers led small group (1 instructor: 5 students), live scanning sessions. Evaluations were conducted before and after each session using expert validated multiple choice questions testing general and procedural knowledge, image recognition and interpretation. Volunteer students were evaluated via direct observation of live scanning using an objective structured assessment of technical skills (OSAT) based on the O-score and then re-evaluated at 2 months post-training to assess PoCUS skills retention. Results: 40 second year medical students participated in extended Focused Assessment with Sonography for Trauma (eFAST), cardiac, and gallbladder PoCUS sessions. The live-training sessions significantly improved student PoCUS knowledge beyond what they learned independently for eFAST (p &lt; 0.001), cardiac (p &lt; 0.001), and gallbladder (p = 0.02). The largest improvement was noted in procedural knowledge test scores improving from 44.0% to 84.0% (n = 38). 16 students were evaluated after each session with a mean O-score of 2.37. 8 students returned two months later to be re-evaluated demonstrating a change in O-scores for eFAST (2.00 to 2.38, p = 0.15), cardiac (2.28 to 2.00, p = 0.32), and gallbladder (2.91 to 1.88, p &lt; 0.001). Conclusion: Procedural PoCUS knowledge benefited the most with hands-on training. eFAST and cardiac PoCUS competency was maintained over time while gallbladder PoCUS competency degraded suggesting that targeted PoCUS skills training may be possible. Further study is required to determine the best use of PoCUS resources in undergraduate medical education.

scholarly journals Clinical supervisors’ perceptions of podiatry students’ preparedness for clinical placement and graduates’ preparedness for podiatry practice in Australia: An exploratory study

2021 ◽  
Vol 22 (2) ◽  
pp. 1-22
Author(s):  
Katrina Reynolds ◽  
Michelle McLean
Keyword(s):  
Clinical Practice ◽  
Communication Skills ◽  
Clinical Competence ◽  
Clinical Skill ◽  
Skills Training ◽  
Clinical Placement ◽  
Clinical Placements ◽  
Clinical Supervisors ◽  
Podiatry Students ◽  
Hands On

Introduction: Little is known about Australian podiatry students’ preparedness for clinical placement and graduates’ preparedness for clinical practice. This qualitative study explored clinical supervisors’ perceptions of podiatry students’ and graduates’ preparedness-related challenges and their recommendations for improvement.Methods: Eleven registered podiatrists who had supervised or were still supervising students were interviewed. Transcribed interviews were thematically analysed. Benner’s (1984) stages of clinical competence from novice to expert informed the study.Results: Clinical supervisors were divided about students’ preparedness for clinical placements, with their perceptions ranging from generally prepared (n = 2) to unsure (n = 5) to unprepared (n = 4). They commented on junior versus senior students, institutional differences and specific clinical skill deficiencies, e.g., scalpel debridement and patient communication skills. Perceived challenges for students on placement included poorly developed clinical skills and low self-efficacy, both stemming primarily from insufficient hands-on experience. Participants suggested that for improved placement preparedness, students required better quality clinical experiences and communication skills training. Being work-ready, which most graduating Australian podiatrists were reported to be, involved being safe and self-efficacious. Participants also suggested that a supportive clinical environment, an internship and more advanced interpersonal skills would facilitate preparedness. Conclusion: In terms of Benner’s (1984) framework, during training, podiatry students should be considered novices, and they should be considered advanced beginners on graduation. An entry-level graduate should not be expected to be competent across all areas of clinical practice. Hands-on clinical practice during placements was needed for moving successfully through Benner’s (1984) stages of clinical competence. While clinical supervisors believed that podiatry training generally prepared students for clinical practice immediately following graduation, they asserted that manual clinical and communication skills improvement is required for clinical placements.

scholarly journals Impact of COVID-19 on medical undergraduate students’ academics and its ramifications

2020 ◽  
Vol 0 ◽  
pp. 1-4
Author(s):  
Arshi Syal ◽  
Yajur Arya ◽  
Monica Gupta
Keyword(s):  
Medical Education ◽  
Medical Students ◽  
Online Teaching ◽  
Clinical Skills ◽  
Univariate Analysis ◽  
Skills Training ◽  
Online Questionnaire ◽  
Medical Undergraduate ◽  
Hands On ◽  
The Impact

Objectives: COVID-19 pandemic has dramatically affected undergraduate medical education all over the world. This effect is most noteworthy on the medical students as clinical orientation and hands-on training are crucial toward development of basic medical skills. Various modifications to the methods of online teaching have been adopted in response to this pandemic to maintain continuity of medical education; however, we do not yet know the implications of this change. Material and Methods: To study the impact of this pandemic on medical students and to have a first-hand estimate of the adversities and challenges faced by them, an online questionnaire-based survey was conducted, administered through Google Forms maintaining anonymity. They were asked a series of multiple choice questions pertaining to the effects of this pandemic on their curriculum and academic activities. The responses received were analyzed by univariate analysis. Results: Almost half (46.4%) of students reported a decreased interest in medicine after suspension of hands on teaching/practical classes. A total of 136 respondents (69.38%) felt that they became less productive in studies during the pandemic. Approximately 74% respondents felt less motivated to study at home. More than two-thirds of the respondents felt that on graduation, their clinical skills will be inferior to the students who graduated during the “non-COVID” era. About 84.69% of students believed that their examinations should be postponed hoping to get appropriate clinical experience once things normalize. Conclusion: Majority of the students feel less motivated and less productive, amidst the transition. The major area that has been compromised is the clinical skills training, a crucial adjunct to theoretical teaching in medical schools, and almost all students believe that their clinical skills in the long term would remain inferior to those who graduated before this pandemic.

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 Workplace Based Assessment in Obstetrics and Gynecology Clerkship to Detect Learning Gaps

2019 ◽  
Vol 43 (1) ◽  
pp. 181-186
Author(s):  
Raquel Autran Coelho ◽  
Francisco das Chagas Medeiros ◽  
Arnaldo Aires Peixoto Júnior ◽  
Rosiane Viana Zuza Diniz ◽  
Danette McKinley ◽  
...  
Keyword(s):  
Medical Students ◽  
Physical Examination ◽  
Clinical Judgment ◽  
Skills Training ◽  
Faculty Members ◽  
Assessment System ◽  
Obstetrics And Gynecology ◽  
Cross Sectional ◽  
Bivariate Correlation ◽  
Workplace Based Assessment

ABSTRACT Background An outcome-based curriculum helps to communicate expectations of performance to students and clinical teachers. The Mini Clinical Evaluation Exercise (mini-CEX) is a useful tool for workplace-based formative assessment. The objective of this study was to use workplace-based assessment and student feedback to evaluate an Obstetrics and Gynecology (Ob&Gyn) clerkship curriculum. Methods A cross-sectional study was conducted with faculty members and medical students in an Ob&Gyn clerkship. The Mini-CEX was introduced into the clerkship assessment system, together with multiple choice question (MCQ) tests. This tool evaluates the history collection, physical examination, clinical judgment, professionalism and humanism, and also gives an overall score at the end of the test. At the end of the rotation, questionnaires were used to collect the students’ perceptions about their skills acquisition during the program. The results of the Mini-CEX, the MCQ test, and questionnaire responses were compared, to determine the extent to which learning objectives were achieved. Results three faculty members assessed 84 medical students using the mini-CEX during the four-month clerkship. The scores for the physical examination and clinical judgment skills were lower, compared to those of the interviewing skills. Based on the students’ feedback, ratings for physical examination and counseling preparation were rated as “inadequate”, especially for the topic breaking bad news. The bivariate correlation between the mini-CEX skills and MCQ test scores showed a positive relationship (r = 0.27). Although they assess different skills on the Muller pyramid, there appears to be a relationship between “Knowing” and “Doing”. These findings will help curriculum managers to identify important gaps in the rotation design and delivery. Based on these results, training in the skills workshop during the first month of the rotation was initiated, in addition to previous simulated training during the third year of medical course. Conclusions The introduction of the mini-CEX offers critical information to identify and refine important curriculum elements in the clinical years. Based on this, physical examination and communications skills training were initiated in the skills workshop.

scholarly journals COVID-19 Pandemic and Academic Speculation of Medical Students of Bangladesh: A Cross-sectional, Comparative Study

2021 ◽  
Author(s):  
Fatema Johora ◽  
Asma Akter Abbasy ◽  
Fatiha Tasmin Jeenia ◽  
Mithun Chandro Bhowmik ◽  
Priyanka Moitra Moitra ◽  
...  
Keyword(s):  
Medical Students ◽  
Comparative Study ◽  
Financial Burden ◽  
Clinical Skill ◽  
Meaningful Learning ◽  
Learning Opportunities ◽  
Cross Sectional ◽  
Career Plan ◽  
Social Distancing ◽  
Future Career

Background:COVID-19 pandemic has caused unprecedented disruptions worldwide including education system. While the necessary focus has been on patient care andwellbeing of healthcare professionals, the impacts on medical students need to be discussed. Methods: This cross-sectional comparative study was conducted to evaluate the academic speculation of medical students studying in government and nongovernment institute during COVID-19 pandemic. A structured questionnaire survey linked in the google form was used as study instrument and was distributed among study population through email, messenger, whatsapp and other social media. Total 1020 students were participated in the study.Results:In this research, 441 (43.24%) and 579 (56.77%) students were from government and non-government medical colleges respectively. Opinion of both group was almost similar regarding disruption of medical education, loss of clinical skills and competency, future career plan, and stress and anxiety but significant differences were observed between both group regarding issue of financial burden, meaningful learning opportunities, fear of getting infected and maintenance of social distancing in hostel. Conclusion: The study revealed similar kind of viewpoint about disruption of education, loss of clinical skill and competency, changing aspects of future career plan and increased level of stress and anxiety among medical students of government and non-government institutes of Bangladesh but different speculations were found regarding issue of financial burden, meaningful learning opportunities, fear of getting infected and possibility of maintenance of social distancing in hostel.

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