Abstract
BackgroundThe correct performance of a structured facial examination presents a fundamental clinical skill to detect facial pathologies. However, many students are not adequately prepared in this basic clinical skill. Many argue that the traditional ‘See One, Do One’ approach is not sufficient to fully master a clinical skill. ‘Mental Training’ has successfully been used to train psychomotor and technical skills in sports and other surgical fields, but its use in Oral and Maxillofacial Surgery is not described. We conducted a quasi-experimental to determine if ‘Mental Training’ was effective in teaching a structured facial examination.MethodsSixty-seven students were randomly assigned to a ‘Mental Training’ and ‘See One, Do One’ group. Both groups received standardized video instruction on how to perform a structured facial examination. The ‘See One, Do One’ group then received 60 min of guided physical practice while the ‘Mental Training’ group actively developed a detailed, stepwise sequence of the performance of a structured facial examination and visualized this sequence subvocally before practicing the skill. Student performance was measured shortly after (T1) and five to 10 weeks (T2) after the training by two blinded examiners (E1 and E2) using a validated checklist.ResultsGroups did not differ in gender, age or in experience. The ‘Mental Training’ group averaged significantly more points in T1 (pE1 = 0.00012; pE2 = 0.004; dE1 = 0.86; dE2 = 0.66) and T2 (pE1 = 0.04; pE2 = 0.008, dE1 = 0.37; dE2 = 0.64) than the ‘See One, Do One’ group. The intragroup comparison showed a significant (pE1 = 0.0002; pE2 = 0.06, dE1 = 1.07; dE2 = 0.50) increase in clinical examination skills in the ‘See One, Do One’ group, while the ‘Mental Training’ group maintained an already high level of clinical examination skills between T1 and T2.Discussion‘Mental Training’ is an efficient tool to teach and maintain basic clinical skills. In this study ‘Mental Training’ was shown to be superior to the commonly used ‘See One, Do One’ approach in learning how to perform a structured facial examination and should therefore be considered more often to teach physical examination skills.
Highlights
The correct performance of a structured facial examination presents a fundamental clinical skill to detect facial pathologies
Practical skills must be learned by every medical student regardless of her or his future specialization [1]
Studies show that students consider the training of practical skills in the context of their medical education as insufficient [2] and there are still shortcomings in the training of basic clinical skills such as the physical examination in undergraduate medical education [3,4,5]
Summary
The correct performance of a structured facial examination presents a fundamental clinical skill to detect facial pathologies. In 1889, Halsted introduced a system in which medical students completed a university-sponsored, hospital-based surgical training program [6]. Halsted’s model of ‘See One, Do One, Teach One’ is based on acquiring increasing amounts of responsibility that culminate in near independence. Halsted was interested in developing a system to train surgeons, and in creating teachers and role models [7]. Today this approach is labelled as the main component of clinical-bedside teaching. Students learn by watching an expert explaining and demonstrating a skill This is followed by the first independent performance of the skill, which is mostly with a patient [7]. The health care system is facing increased economic pressure and scarcity of resources [9]
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