A Novel Pediatric Clinical Skills Curriculum to Prepare Medical Students for Pediatrics Clerkship

Abstract

Introduction Medical students feel poorly prepared to examine pediatric patients during clerkship. Our institution’s introduction to clinical skills course lacked practice with pediatrics physical examination skills. We developed a novel clinical skills curriculum to increase students’ confidence in examining pediatric patients. Methods Ericsson’s deliberate practice conceptual framework guided curriculum design. We utilized a flipped-classroom model to teach the newborn examination. Students watched a video, then practiced with manikins and patients. For the child examination, students attended a lecture and practiced with hospitalized children and facilitators. Students then participated in a Home, Education, Eating/Exercise, Activities/Employment, Drugs, Suicidality, Sexuality, Safety (HEEADSSS) didactic and role play activity. Before and after participation, students completed REDCap surveys ranking confidence in performing pediatric examinations and identifying normal examination findings on a Likert scale (1 = “Not at all confident,” 4 = “Extremely confident”). We analyzed data using Wilcoxon rank sum tests. Results A total of 97 students participated in the curriculum. Respectively, 56 (58%) and 32 (30%) students completed pre- and post-participation surveys. Post-participation, students reported increased confidence in identifying normal infant (median [interquartile range]; (2 [2,2] vs 4 [3,4]; p < 0.001) and child (2 [2,2] vs 3 [3,4]; p < 0.001) examination findings as well as HEEADSSS assessment components (2 [1.5,2] vs 4 [3,4]; p < 0.001), and had significantly higher scores on confidence performing infant (2 [2,2.5] vs 4 [3,4]; p < 0.001), child (2 [2,2] vs 3 [3,4]; p < 0.001), and HEEADSSS assessment (2 [2,3] vs 4 [3,4]; p < 0.001). Discussion This multi-modal curriculum emphasizing pediatric examination skills improved students’ confidence in pediatric-specific knowledge and skills prior to clerkship.