A Prospective Study of the Longitudinal Effects of an Embedded Specialty Curriculum on Physical Examination Skills Using an Ophthalmology Model

Mottow-Lippa, Linda; Boker, John R.; Stephens, Frances

doi:10.1097/acm.0b013e3181bb2d51

Cited by 35 publications

(39 citation statements)

References 9 publications

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“…It is important to emphasize however that these scores derived from checklists items measuring only the exam technique and not detection and interpretation of the clinical signs found. Maintenance of these clinical skills is again most likely to be explained by continuous practice after the initial acquisition, since as, at least for skills related to the examination of the eye [21], additional training successfully reinforces performance, which progressively decays with non practice. Our findings, obtained in an educational scenario characterized by a richness of opportunities for practicing clinical skills, as already mentioned, are in accordance Fig.…”

Section: Discussionmentioning

confidence: 99%

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Retention of Knowledge and Clinical Skills by Medical Students: A Pro-spective, Longitudinal, One-Year Study Using Basic Pediatric Cardiology as a Model

Amaral¹,

Troncon

2013

TOMEDEDUJ

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Abstract:Background: Retention of early-taught knowledge and fundamental clinical skills, albeit essential in medical education, has not been extensively investigated. This study is aimed at assessing prospectively the retention of knowledge and skills related to communication with patients and the physical examination by fourth year medical students after an introductory course in basic pediatric cardiology.Methods: Three cohorts of fourth year medical students aged 21-26 years volunteered for the study. All students (N = 130) were assessed immediately after the teaching period and after six months (N = 42) and after one year (N = 21) later. Assessments included a 40 multiple-choice question (MCQ) test and an 8-station objective structured clinical examination (OSCE) focused on communication with patients, physical examination and interpretation of diagnostic tests (chest radiographs and electrocardiograms). Cases were portrayed by either real, rehearsed patients or standardized patients. Student performance was assessed by trained staff members using structured checklists.Results: For all aspects of knowledge assessed, scores obtained in the second and the third assessment were significantly lower than those verified in the first assessment. There were no significant differences between the three assessments regarding overall clinical performance and data for communication with patients and physical examination. Concerning diagnostic tests interpretation, scores obtained in the second and third assessment were significantly lower than those verified in the first assessment. Paired analysis of the results obtained for the 21 students who took the three assessments showed similar results, except for a trend for improvement in clinical skills.Conclusions: Medical student retention of clinical sciences knowledge follows a pattern similar to that found in other scientific domains, characterized by progressive decay after initial acquisition. In contrast, fundamental clinical skills, such as communication with patients and physical examination are substantially retained, which could be ascribed to continuous practice. These findings should be taken into account for devising instructional strategies for enhancing student knowledge and clinical skills maintenance.

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Section: Discussionmentioning

confidence: 99%

“…Nevertheless, the retention of physical examinations skills has only been investigated in very specific settings, such as eye examinations [21] and studies on more general skills are even more scarce.…”

Section: Introductionmentioning

confidence: 99%

Retention of Knowledge and Clinical Skills by Medical Students: A Pro-spective, Longitudinal, One-Year Study Using Basic Pediatric Cardiology as a Model

Amaral¹,

Troncon

2013

TOMEDEDUJ

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“…Research has shown that proficiency with ocular fundus examination, as with many other skills, decreases without regular reinforcement. 12 Furthermore, there is evidence that most medical students are uncomfortable with direct ophthalmoscopy. 11 The preservation of the ocular fundus examination as a skill important to neurologists and primary care physicians will likely require creative solutions that (1) improve the diagnostic yield of ocular fundus examination, (2) reinforce the vital role of ocular fundus examination in patient care, and (3) increase enthusiasm for the ocular fundus examination that some may already view as a dying art.…”

Section: Ophthalmoscopy In Medical Student Educationmentioning

confidence: 99%

The demise of direct ophthalmoscopy

et al. 2015

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SummaryOcular funduscopy appears to be a dying art. Physicians and medical students alike lack confidence in the use of an ophthalmoscope. As a result, few clinicians perform ophthalmoscopy, and many who do are unable to reliably detect abnormalities of the ocular fundus. Approaches to remediation in undergraduate medical education have included simulators, longitudinal skill reinforcement, Web-based teaching, and other techniques. Preservation of the ophthalmoscopic art has been hindered by technical difficulty, waning enthusiasm for ophthalmoscopy, and even discouragement from preceptors in medical education. Ocular fundus photography may serve a role in medical education to help improve student confidence in interpretation of ocular fundus findings and improve awareness of the importance of examination of the ocular fundus. Because neurology clerkships and clinical practices remain an important forum for honing ocular funduscopy skills, the neurologist should be familiar with novel alternative techniques that facilitate examination of the ocular fundus.

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“…However, even the most innovative approach to teaching is unlikely to take full effect if only implemented once throughout a six-year curriculum. Repeated training reduces the rate at which skills are lost [22,23] but its implementation can be challenging given the growing body of information to be covered in undergraduate medical education. However, even ongoing training may not be sufficient unless coupled with appropriate exams.…”

Section: Implications For Teachingmentioning

confidence: 99%

How can we improve teaching of ECG interpretation skills? Findings from a prospective randomised trial

Raupach

Harendza

Anders

et al. 2016

Journal of Electrocardiology

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A Prospective Study of the Longitudinal Effects of an Embedded Specialty Curriculum on Physical Examination Skills Using an Ophthalmology Model

Cited by 35 publications

References 9 publications

Retention of Knowledge and Clinical Skills by Medical Students: A Pro-spective, Longitudinal, One-Year Study Using Basic Pediatric Cardiology as a Model

Retention of Knowledge and Clinical Skills by Medical Students: A Pro-spective, Longitudinal, One-Year Study Using Basic Pediatric Cardiology as a Model

The demise of direct ophthalmoscopy

How can we improve teaching of ECG interpretation skills? Findings from a prospective randomised trial

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