Students Sitting Medical Finals–-Ready to be House Officers?

Abstract

An initial survey of students approaching qualification and the preregistration house officer year revealed anxiety about competence in several important clinical skills. A questionnaire study was then undertaken to assess, first, the extent to which students had attained the skills required for the preregistration year and, second, the amount of training in these skills provided during the preregistration year. 122 medical students taking their final examinations were asked about training and practice in eight core clinical skills, and 84 graduates from the same school, approaching the end of their preregistration year, were asked about postgraduate training in these skills. The response rate of each group was 100%. Of the eight skills studied, most had been performed few times by the students at qualification. Less than half the current preregistration house officers could recall training being given in any of the skills studied. There were no significant differences in house-officer training between teaching hospitals and district general hospitals. Regarding needlestick injuries, nearly two-thirds of preregistration house officers were unable to recall any training at either undergraduate or postgraduate level. These results suggest that training in clinical skills can be improved. Training is already changing with use of clinical skills laboratories and logbooks. We also recommend mandatory needlestick training both in undergraduate programmes and in induction courses for preregistration house officers.

Occupational exposure to sharp injuries among medical and dental house officers in Nigeria

“…with actual clinical experience [13,14] Since the practice of medicine involves a level of apprenticeship, many of the duties of HOs expose them rather prematurely to handling potentially hazardous sharp instruments and objects (e.g. setting up lines, venepuncture [13,15], as well as taking blood samples, saliva for laboratory testing, and tissues for biopsies).…”

“…setting up lines, venepuncture [13,15], as well as taking blood samples, saliva for laboratory testing, and tissues for biopsies). Additionally, dental HOs administer local anesthetics in procedures like simple tooth extraction, root canal fillings, and restorations; and they use instruments such as sharp forceps and elevators.…”

“…Another factor is inconsistent compliance with preventive measures like the use of gloves and the recapping of the used needles. Lack of handling skills and caution, freak accidents, and iatrogenic incidents often result in sharp injuries and exposure to contaminated body fluids [13,16,17]. Sometimes it could be the HOs' anxiety and stress levels [13,18], which may potentially increase the possibility of injuries [19].…”

“…Lack of handling skills and caution, freak accidents, and iatrogenic incidents often result in sharp injuries and exposure to contaminated body fluids [13,16,17]. Sometimes it could be the HOs' anxiety and stress levels [13,18], which may potentially increase the possibility of injuries [19]. Although there are well documented post-exposure protocols, evidence suggests that many HOs, like other members of medical personnel, do not comply with them.…”

Student-selected components in surgery: providing practical experience and increasing student confidence

“…This and other studies found self-assessment of competence by students to be positively correlated with their frequency of procedure performance [14,15]. Goodfellow et al [16] surveyed 122 final-year medical students at a UK university, in eight ''core'' clinical skills, and found that the majority of these skills had been performed few times by students over their entire undergraduate course. A Dutch study showed that medical schools cannot rely on clerkships to train students in basic clinical skills to the expected standard [17].…”