Abstract

A sound knowledge of the scientific basis of medicine is a prerequisite for successful learning and understanding of clinical issues. Teachers of clinical medicine, however, often complain that their students' knowledge on the scientific basis of medicine is too low. In the clinical curricula of most medical schools in Germany, students rely on self-directed learning efforts to optimize their knowledge of basic issues for the study of clinical medicine. Using anatomy and otorhinolaryngology (ENT) as an example, we have compared the effects of a structured seminar for recall of anatomical knowledge and its elaboration under clinical perspective with self-directed learning efforts of the same contents. Effects on clinical performance and students confidence were compared in a randomized trial. We found that the clinical performance of students was significantly higher (6.9%) in the seminar group compared with the control group. Furthermore, the students' self-estimation of clinical competence was increased in the seminar group and they were more content with their clinical course in ENT. Based on the design of the study we believe that the improvement of clinical performance was a longterm effect due to deeper understanding of the clinical problems among participants of the seminar. Irrespective of their experimental study group, most students asked for more integration of seminars on the scientific basis of medicine into the clinical curriculum. With the significant increase in clinical performance shown in this study and the limited effort needed for implementation, these seminars could be an efficient way to improve the quality of teaching in clinical medicine.

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