Clerkship maturity: does the idea of training clinical skills work?
Ontology highlight
ABSTRACT:
SUBMITTER: Stosch C
PROVIDER: S-EPMC3159202 | biostudies-other | 2011
REPOSITORIES: biostudies-other
Publications
Clerkship maturity: does the idea of training clinical skills work?
Stosch Christoph C Joachim Alexander A Ascher Johannes J
GMS Zeitschrift fur medizinische Ausbildung 20110808 3
<h4>Background</h4>With the reformed curriculum "4C", the Medical Faculty of the University of Cologne has started to systematically plan practical skills training, for which Clerkship Maturity is the first step. The key guidelines along which the curriculum was development were developed by experts. This approach has now been validated.<h4>Materials and methods</h4>Both students and teachers were asked to fill in a questionnaire regarding preclinical practical skills training to confirm the con ...[more]
Similar Datasets
Project description:IntroductionAssessment of medical students' clinical skills (CS) remains a challenge. Little is known about early predictors of future CS performance. This study examines the relationship between students' pre-clerkship clinical skills (PCCS) performance and year 3 clerkship performance measures.MethodsThe authors performed a retrospective analysis of four medical student cohorts who matriculated between 2014 and 2017 and participated in a longitudinal pre-clerkship CS curriculum. A total of 440 students were included in the analyses. Students' clinical skills were assessed through a series of PCCS exams, each consisting of a single standardized patient encounter. First-year PCCS exams assessed history taking, physical examination, professionalism, and communication skills; second-year PCCS exams also assessed clinical documentation and clinical reasoning skills. Evaluators assigned a grade of "satisfactory," "borderline," or "unsatisfactory" for each skill set. Regression analyses compared year 3 performance outcomes between students with one or more "unsatisfactory" or "borderline" PCCS skill set grades and students assessed as "satisfactory" for all PCCS skill set assessments.ResultsThirty-two percent (n = 140) of the 440 students had at least one borderline or unsatisfactory (US) PCCS skill set grade. These students performed significantly worse on year 3 National Board of Medical Examiner subject exams, workplace-based clinical performance evaluations, and overall year 3 performance compared to students who passed all PCCS exam components. In addition, a higher percentage of students with PCCS performance deficiencies failed the United States Medical Licensing Examination Step 2 CS exam on the first attempt versus students who passed all PCCS exam components.ConclusionsPCCS exam performance at our institution aligned with future student performance on multiple year 3 clerkship outcome measures. This pre-clerkship performance data can be used to identify at-risk students who would benefit from additional resources to achieve competency in the clerkship environment and future medical training.Supplementary informationThe online version contains supplementary material available at 10.1007/s40670-022-01519-8.
| S-EPMC8886335 | biostudies-literature
Project description:Continuity is critical for safe patient care and its absence is associated with adverse outcomes. Continuity requires handoffs between physicians, but most published studies of educational interventions to improve handoffs have focused primarily on residents, despite interns expected to being proficient. The AAMC core entrustable activities for graduating medical students includes handoffs as a milestone, but no controlled studies with students have assessed the impact of training in handoff skills. The purpose of this study was to assess the impact of an educational intervention to improve third-year medical student handoff skills, the durability of learned skills into the fourth year, and the transfer of skills from the simulated setting to the clinical environment. Trained evaluators used standardized patient cases and an observation tool to assess verbal handoff skills immediately post intervention and during the student's fourth-year acting internship. Students were also observed doing real time sign-outs during their acting internship. Evaluators assessed untrained control students using a standardized case and performing a real-time sign-out. Intervention students mean score demonstrated improvement in handoff skills immediately after the workshop (2.6-3.8; p < 0.0001) that persisted into their fourth year acting internship when compared to baseline performance (3.9-3.5; p = 0.06) and to untrained control students (3.5 vs. 2.5; p < 0.001, d = 1.2). Intervention students evaluated in the clinical setting also scored higher than control students when assessed doing real-time handoffs (3.8 vs. 3.3; p = 0.032, d = 0.71). These findings should be useful to others considering introducing handoff teaching in the undergraduate medical curriculum in preparation for post-graduate medical training. Trial Registration Number NCT02217241.
| S-EPMC4749641 | biostudies-literature
Project description:BackgroundThe effectiveness of simulation-based training for skill acquisition is widely recognized. However, the impact of simulation-based procedural training (SBPT) on pre-clerkship medical students and the retention of procedural skills learned through this modality are rarely investigated.MethodsA prospective cohort study was conducted among pre-clerkship medical students. Learners underwent SBPT in venipuncture in the skills laboratory. Assessments were conducted at two main points: 1) immediate assessment following the training and 2) delayed assessment one year after training. Learner self-assessments, independent assessor assessments for procedural competency, and communication skills assessments were conducted in both instances. The students were assessed for their competency in performing venipuncture by an independent assessor immediately following the training in the simulated setting and one-year post-training in the clinical setting, using the Integrated Procedural Protocol Instrument (IPPI). The student's communication skills were assessed by standardized patients (SP) and actual patients in the simulated and clinical settings, respectively, using the Communication Assessment Tool (CAT).ResultsFifty-five pre-clerkship medical students were recruited for the study. A significant increase was observed in self-confidence [mean: 2.89 SD (Standard Deviation) (0.69)] and self-perceived competency [mean: 2.42 SD (0.57)] in performing venipuncture, which further improved at the delayed assessment conducted in the clinical setting (p < 0.001). Similarly, the IPPI ratings showed an improvement [immediate assessment: mean: 2.25 SD (1.62); delayed assessment: mean: 2.78 SD (0.53); p < 0.01] in venipuncture skills when assessed by an independent assessor blinded to the study design. A significant difference (p < 0.01) was also observed in doctor-patient communication when evaluated by SPs [mean: 2.49 SD (0.57)] and patients [mean: 3.76 SD (0.74)].ConclusionSimulation-based venipuncture training enabled students to perform the procedure with confidence and technical accuracy. Improved rating scores received at a one-year interval denote the impact of clinical training on skills acquisition. The durability of skills learned via SBPT needs to be further investigated.
| S-EPMC10559527 | biostudies-literature
Project description:BackgroundAtraumatic needles are proposed to lower complication rates after lumbar puncture (LP). Only a minority of physicians use such needles. Here we aimed to assess the impact of specific training in LP during clinical clerkship on the proportion of medical students using atraumatic needles.MethodsWe performed a case-control study comparing medical students undergoing clinical clerkship and students undergoing specific LP training. The 176 students of a class underwent training in LP just before beginning their clinical rotations. This training consisted of 45 minutes of theoretical training and a 90-minute practical session with a dummy. Twenty students were selected from the class at random, and their competence was assessed with a multiple choice questionnaire (MCQ) and an objective structured clinical examination (OSCE), nine months after the specific training. These 20 cases were compared with 20 students randomly selected from a class of 180 students who had not undergone specific training in LP and were at the end of their clinical clerkship.ResultsWe found that 60% of the students with specific training and 25% of those with classic clinical training used an atraumatic needle during the OSCE (p = 0.025). The mean MCQ (/100) scores obtained were 57±15 and 60±15 for the specific and classic training groups, respectively (p = 0.35). Overall OSCE score was similar in the two groups (63.5±9.3 vs. 65.8±9.3; p = 0.20).ConclusionVery few practicing physicians use atraumatic needles, which limits the teaching of their use to medical students. Specific training durably increases the use of appropriate needles.
| S-EPMC6557568 | biostudies-literature
Project description:ObjectiveThe aim of the study was to verify if soft-skills training is an effective intervention in reducing work-related stress among miners, that is, people who run the risk of losing health and/or life due to unpredictable natural forces or human error at work.BackgroundThe motivation for the intervention was based on Job Demands-Resources model where soft skills are job resources that help individuals to cope with or prevent high demands of the environment. The needed skills as well as work demands were first investigated and then a custom training was developed. The rationale for introducing soft-skills training into the work environment can be seen as compatible with the Human Capital Model (HCM) which is designed to stimulate positive organizational behaviour by providing an effective approach to ensure employees' adequate coping with work-related stress.Method96 volunteer employees were assigned to intervention (n = 48) and comparison (n = 48) groups. 16-hour tailored training covered tasks and simulation games related to communication, teambuilding, self-management and conflict resolution skills. Job Content Questionnaire, Occupational Stress Indicator (modified to fit the mining environment) and General Health Questionnaire were used in the study. A MANOVA with effect-size measures was conducted.ResultsResults revealed a significant increase in decision latitude and social support for the trainees. A substantial decrease in stress was also observed, along with a significant decrease in general health problems. There were no such changes in the comparison group.ConclusionsA soft-skills training, including communication, teamwork, self-motivation and conflict-resolution skills, helped participants to cope better with the stressful environment and improved their mental health. These effects lasted three months later.ApplicationThe intervention improved miners' psychosocial health and the strategies of coping with stress, which increased safety and health in the company. Investigating the effectiveness of such interventions included in the general Human Capital Model, as it was done in the study, might be a step forward towards building an interdisciplinary approach for health and safety and human resources.
| S-EPMC10943617 | biostudies-literature
Project description:Today, skills laboratories or "skills labs", i.e. specific practical skill training facilities, are a firmly established part of medical education offering the possibility of training clinical procedures in a safe and fault-forging environment prior to real life application at bedside or in the operating room. Skills lab training follows a structured teaching concept, takes place under supervision and in consideration of methodological-didactic concepts, ideally creating an atmosphere that allows the repeated, anxiety- and risk-free practice of targeted skills. In this selective literature review, the first section is devoted to (I) the development and dissemination of the skills lab concept. There follows (II) an outline of the underlying idea and (III) an analysis of key efficacy factors. Thereafter, (IV) the training method's effectiveness and transference are illuminated, before (V) the use of student tutors, in the sense of peer-assisted-learning, in skills labs is discussed separately. Finally, (VI) the efficiency of the skills lab concept is analyzed, followed by an outlook on future developments and trends in the field of skills lab training.
| S-EPMC5003146 | biostudies-other
Project description:BackgroundDespite the high burden of musculoskeletal (MSK) diseases, few generalists are comfortable teaching MSK physical examination (PE) skills. Patient Partners® in Arthritis (PP®IA) is a standardized patient educator program that could potentially supplement current MSK PE teaching. This study aims to determine if differences exist in MSK PE skills between non-MSK specialist physician and PP®IA taught students.MethodsPre-clerkship medical students attended 2-hour small group MSK PE teaching by either non-MSK specialist physician tutors or by PP®IA. All students underwent an MSK OSCE and completed retrospective pre-post questionnaires regarding comfort with MSK PE and interest in MSK.Results83 students completed the OSCE (42 PP®IA, 41 physician taught) and 82 completed the questionnaire (42 PP®IA, 40 physician taught). There were no significant differences between groups in OSCE scores. For all questionnaire items, post-session ratings were significantly higher than pre-session ratings for both groups. In exploratory analysis PP®IA students showed significantly greater improvement in 12 of 22 questions including three of five patient-centred learning questions.ConclusionsPP®IA MSK PE teaching is as good as non-MSK specialist physician tutor teaching when measured by a five station OSCE and provide an excellent complementary resource to address current deficits in MSK PE teaching.
| S-EPMC3190339 | biostudies-literature
Project description:To investigate the overall experiences of clinical pharmacy students during their clinical attachments and to understand the breadth and depth of clinical skills provided by their preceptors.A cross-sectional study using a self-administered questionnaire containing 34 items to obtain feedback from the clerkship students from June to July 2015. Data analysis was performed to calculate mean, standard deviation, percentages, and multiple logistic regression using Statistical Package for the Social Sciences (SPSS) software Version 22. Statistical significance was set at P<0.01.All 58 clerkship students actively participated in the study, yielding a response rate of 100%. While students ranked their clerkship experience as moderate, >15% remarked that they did not receive enough opportunities to hone their pharmaceutical care documentation skills. A relatively high percentage of students (32.8%) strongly agreed that their preceptors had provided ample opportunity to discuss the patient problems at the bedside and encouraged them to express their opinions regarding patients' drug therapeutic issues. This study also revealed that students' continuity in developing their therapeutic and disease process knowledge was significantly associated with the preceptor's ability to provide adequate training and orientation (P =0.01), engagement in clinical pharmacy activities (P =0.01), regular review of students' work (P =0.01), and instruction to students before entering clinical sites (P =0.00).The findings of this study reveal that a majority of the students were moderately satisfied with the clinical training program and preceptors need to demonstrate effective pharmaceutical care processes in their clinical sites.
| S-EPMC4822799 | biostudies-other
Project description:Multiple experts in clinical skills remediation recommend early identification to support struggling learners, but there is minimal documentation on implementation of these programs. We share one school's outcomes-based research utilizing the formative assessment for learning model to early-identify pre-clerkship students struggling with clinical skills using formative OSCEs (F-OSCE). Student scores were monitored over longitudinal F-OSCE experiences as part of a curricular innovation. Points towards early identification accumulated when a student's score fell below the 80% threshold for each section of an OSCE. Students who accumulated enough points were advised of the need for intervention, and coaching was recommended. Students were surveyed about their experiences with the program. The objective was to explore whether this early identification program and coaching intervention had a positive impact on subsequent OSCE performance. Of 184 students in 2 cohorts who completed F-OSCEs, 38 (20.7%) were flagged for early identification. Of these, 17 (44.7%) sought additional help by voluntarily participating in the coaching program. Students who participated in extra clinical skills coaching demonstrated statistically significant improvements in performance on subsequent FOSCEs, as did the early identified students who did not participate in extra coaching. The greatest impact of coaching intervention was noted in the physical examination domain. This program was effective in identifying students struggling with clinical skills on formative OSCEs. Early identified students demonstrated improvements in subsequent OSCE performance, with those who sought coaching faring slightly better. Development of robust early identification programs as formative assessments of clinical skills and follow-up coaching programs to guide skills development are important implications of this work. Monitoring short- and long-term results for students identified through this approach to see if improvement is sustained is planned.
| S-EPMC8786239 | biostudies-literature
Project description:Background: The expectations of point-of-care ultrasound (PoCUS) in undergraduate clerkship at the University of Ottawa has not been described. We compared clerkship directors' expectations of physical examination skills with PoCUS skills, before and after completing the clerkship rotation. Methods: A pilot-tested, expert developed, bilingual on-line survey consisting of 15 questions was sent to all clerkship directors (23) in December 2019. The survey included questions regarding the expectations of medical students with respect to physical examination and PoCUS using the RIME Framework: none, reporter, interpreter, manager, educator. Results: The response rate was 60.9% (14/23). With regards to physical exam skills, 82.8% of directors had no expectations or expected students to be reporters when starting clerkship. At graduation, 77.5% of directors expected students to be interpreters, managers, or educators. For PoCUS, 100.0% of directors had no expectations or expected students to be reporters when starting clerkship. At clerkship completion, 33.0% of directors felt that students should be interpreters or managers for PoCUS skills. Conclusions: Clerkship directors have low expectations of PoCUS skills for entering and graduating clerks when compared with their physical examination skills despite formal pre-clerkship PoCUS objectives. Enhanced communication and targeted education of directors could improve the PoCUS curriculum.
| S-EPMC9979901 | biostudies-literature