Abstract
BackgroundEnsuring that all medical students achieve adequate clinical skills remains a challenge, yet the correct performance of clinical skills is critical for all fields of medicine. This study analyzes the influence of receiving feedback by teaching associates in the context of achieving and maintaining a level of expertise in complex head and skull examination.MethodsAll third year students at a German university who completed the obligatory surgical skills lab training and surgical clerkship participated in this study. The students were randomized into two groups. Control group: lessons by an instructor and peer-based practical skills training. Intervention group: training by teaching associates who are examined as simulation patients and provided direct feedback on student performance. Their competency in short- and long-term competence (directly after intervention and at 4 months after the training) of head and skull examination was measured.Statistical analyses were performed using SPSS Statistics version 19 (IBM, Armonk, USA). Parametric and non-parametric test methods were applied. As a measurement of correlation, Pearson correlations and correlations via Kendall’s-Tau-b were calculated and Cohen’s d effect size was calculated.ResultsA total of 181 students were included (90 intervention, 91 control). Out of those 181 students 81 agreed to be videotaped (32 in the control group and 49 in the TA group) and examined at time point 1. At both time points, the intervention group performed the examination significantly better (time point 1, p = <.001; time point 2 (rater 1 p = .009, rater 2 p = .015), than the control group. The effect size (Cohens d) was up to 1.422.ConclusionsThe use of teaching associates for teaching complex practical skills is effective for short- and long-term retention. We anticipate the method could be easily translated to nearly every patient-based clinical skill, particularly with regards to a competence-based education of future doctors.
Highlights
Ensuring that all medical students achieve adequate clinical skills remains a challenge, yet the correct performance of clinical skills is critical for all fields of medicine
Due to the complexity of the skills required, especially with regard to technical-manual and psychosocial skills, practical clinical competence and competenceoriented training is of essential importance to university teaching
Many medical licensing boards and medical societies around the world have called for the strengthening of practical clinical skills in undergraduate medical training, as they are currently deemed insufficient [2,3,4,5]
Summary
Ensuring that all medical students achieve adequate clinical skills remains a challenge, yet the correct performance of clinical skills is critical for all fields of medicine. Due to the complexity of the skills required, especially with regard to technical-manual and psychosocial skills, practical clinical competence and competenceoriented training is of essential importance to university teaching. During undergraduate medical training, certain practical skills (e.g. injections, suturing, etc.) should be mastered to ensure a high level of security for both, students and patients. The majority of final year medical students, in Germany but worldwide, rate their practical skills training as average or even poor [6,7,8,9,10,11]. According to Elsenhans [12], students feel like they have received poor guidance from their practicing medical colleagues. Surgeons receive the lowest ranking in the survey, where only 10% of all students reported a very good supervision experience and 20% rated their learning experience as very poor
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