Checklist-based training for essential clinical skills in 3 term MBBS students

Abstract

Background: Undergraduate students find the correct sequence & method of eliciting clinical signs is ambiguous, leading to confusion & reluctance to demonstrate. The 3-term posting is the introduction to clinical skills & it is essential that bedside teaching is organized & delivered well. Studies have shown that a structured clinical training improves students' examination skills. This study aimed to estimate the difference in competence in basic physical examination in students taught by checklist-based training and those taught by standard clinical teaching. Materials and Methods: This was a randomized crossover trial conducted on 3 term MBBS students posted to medicine. Checklists for general physical examination (GPE) and vital sign examination were framed, piloted. Students were divided in to control & test groups by simple randomization. In phase 1, the control group learnt measurement of vital signs by standard clinical teaching in the units. The test group learned using checklist-based demonstration. In phase 2, the groups were interchanged and GPE was taught by checklist method in the test group. Skills were assessed by OSCE after each training. OSCE scores between control & test groups were compared and analysed. Results: Students showed significantly higher scores when GPE was taught by checklist-based method (Test 1.49, control 0.6. P – 0.000). There was no significant difference in OSCE scores in vital sign examination (Test – 1.15, Control 1.19 P – 0.378). Students found the checklist-based method systematic and easy to remember Conclusion: Checklist-based training improves student clinical learning in GPE, though not in vital sign examination. The following core competencies are addressed in this article: Medical knowledge, Patient care, Practice-based learning and improvement.