Abstract
Videos are increasingly being used for teaching clinical skills in medical education. However, most reports on the effectiveness and benefits of videos in medical teaching have come from developed countries. Resource constraints in South African academic hospitals, together with increasing numbers, may apply pressure on the standard of clinical teaching. This study investigated the potential for using video demonstrations to replace the bedside teaching of introductory paediatric clinical examination skills to large groups of medical students. Sixty medical students were randomised to an experimental group that watched a video of a paediatric abdominal examination or to a control group that received a bedside tutorial on the same topic. Immediately afterwards, experienced assessors observed and scored the students in a clinical examination. Data were analysed for the non-inferiority of the video group scores within a 10% margin of the bedside group. Students’ and clinician educators’ perceptions of the two teaching methods and their views on how video instruction could be integrated into the clinical teaching programme were explored. Qualitative data were analysed thematically. The video teaching was non-inferior to the bedside teaching within the 10% margin and did not significantly affect the pass/fail or distinction rates. Students and clinician educators suggested that the videos be used for teaching basic concepts, allowing bedside tutorials to focus on applied learning. The findings have important implications for using video demonstrations to supplement the teaching of clinical skills to large groups of medical students across multiple variably-resourced settings.
Highlights
The global pressure to increase the quantity, quality, and relevance of medical graduates (Frenk et al, 2010) poses a challenge to maintaining current clinical teaching practices
This study investigated whether video demonstrations were at least as good as the bedside teaching and explored medical students’ and clinician educators’ perceptions of the benefits and limitations of video teaching compared to bedside teaching
The mean difference and associated confidence interval were within the non-inferiority margin of 10% for all four measures assessed in the clinical examination performed by the students (Fig. 3)
Summary
The global pressure to increase the quantity, quality, and relevance of medical graduates (Frenk et al, 2010) poses a challenge to maintaining current clinical teaching practices. Undergraduate paediatric clinical training is further compromised by the lack of physical space around the bedside in overcrowded wards and the impracticality of allowing large numbers of students to examine an infant or young child (Craze & Hope, 2006). These challenges hamper the development of the essential clinical, problem-solving, and critical thinking skills required for competent medical graduates (Hornsby et al, 2013; Maudsley & Strivens, 2000; McKeachie, 1980). Observing a demonstration forms the first step in Peyton’s approach to teaching procedural and physical examination skills, which consists of the following steps (Lake & Hamdorf, 2004; Walker & Peyton, 1998): Demonstration: The tutor demonstrates the skill at a normal pace, without commentary
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