Ready to run the wards? – A descriptive follow-up study assessing future doctors’ clinical skills

Abstract

BackgroundRecent studies have shown that clinical tasks only represent a small percentage in the scope of final-year medical students’ activities and often lack sufficient supervision. It appears that final-year medical students are frequently deployed to perform “routine tasks” and show deficits in the performance of more complex activities. This study aimed to evaluate final-year students’ clinical performance in multiple impromptu clinical scenarios using video-based assessment.MethodsWe assessed final-year medical students’ clinical performance in a prospective, descriptive, clinical follow-up study with 24 final-year medical students during their Internal Medicine rotation. Participating students were videotaped while practicing history taking, physical examination, IV cannulation, and case presentation at the beginning and end of their rotation. Clinical performance was rated by two independent, blinded video assessors using binary checklists, activity specific rating scales and a five-point global rating scale for clinical competence.ResultsStudents’ performance, assessed by the global rating scale for clinical competence, improved significantly during their rotation. However, their task performance was not rated as sufficient for independent practice in most cases. Analysis of average scores revealed that overall performance levels differed significantly, whereby average performance was better for less complex and more frequently performed activities.ConclusionsWe were able to show that students’ performance levels differ significantly depending on the frequency and complexity of activities. Hence, to ensure adequate job preparedness for clinical practice, students need sufficiently supervised and comprehensive on-ward medical training.

Demonstrate, observe, assist perform (DOAP) versus structured educational video (SEV) in imparting standard skill in male urinary bladder catheterisation

“…The move towards competency based medical education (CBME) globally had highlighted this need and also the challenges inherent to ensuring achievement of these competencies [1]. Wide variability in procedural skills have been observed among junior doctors even after adoption of CBME raising questions about their readiness to undertake roles expected of them [2]. Many studies have confirmed the positive significant benefit of adding multimedia-based training to traditional text-based training [7].…”

“…Wide variation is observed in skills in performing common bedside clinical procedure of male bladder catheterisation among final phase MBBS students trained through conventional training and assessment [1,2]. Conventional teaching and learning methods may not allow assurance of achievement of competencies in the Indian Medical Graduate IMG.…”

Medical education in Greece: Necessary reforms need to be re-considered

“…Studies conducted in other countries have revealed that the majority of newly graduated physicians, appointed to provide medical service in rural areas, due to lack of clinical experience, are not self-confident to provide appropriate medical care to patients (Goldacre et al 2003;Karakus and S¸enyer 2014;Gazibara et al 2015;Bugaj et al 2018;van der Voort et al 2019). This is particularly true for the Greek young physicians.…”

Demonstrate, Observe, Assist, and Perform versus structured educational video in imparting standard skill in male urinary bladder catheterization

“…Wide variation is observed in skills in performing common bedside clinical procedure of male bladder catheterization among final phase MBBS students trained through conventional training and assessment. 1,2 Conventional teaching and learning methods may not allow assurance of achievement of competencies in the Indian Medical Graduate. 1 Introduction of structured training methods could offer a reliable method of facilitation of learning and assured skill acquisition.…”