L’enseignement par discipline de la sémiologie en deuxième année de médecine améliore l’acquisition des compétences. Exemple de la sémiologie neurologique

Abstract

IntroductionSince 2014–2015, practical teaching of clinical observation skills for 2nd year medical students at our faculty has been discipline-based; previously, each clinical lecturer had to cover all medical fields. We assessed the impact of this teaching reform on the neurological examination skills of medical students in a before-and-after study. MethodsPre-reform 3rd and post-reform 2nd and 3rd year medical students (n=62, n=71 and 52, respectively) had to perform 7 neurological examination items, for which performance criteria had been pre-defined. Subsequently, we assessed whether the mean grade in neurological examination skills during the test at the end of the 2nd year was different between students who had received neurological teaching from a neurologist (n=29) or another specialist (n=102). ResultsThe median [interquartile range] number of items acquired by post-reform 3rd year students (4 [2–5]) was higher than that of pre-reform 3rd year students (2 [1–3]; P<0.001), but lower than that of post-reform 2nd year students (5 [4–6]; P=0.01). The mean grade obtained during the practical test was not different in students trained by a neurologist or another specialist. ConclusionAcquisition of neurological examination skills improved after the teaching reform which consisted of: (1) a discipline-based practical teaching of clinical observation skills; (2) a training of clinical lecturers to teach a limited list of educational objectives; and (3) the introduction of a practical test at the end of the 2nd year of medical studies. However, there was a decline in clinical observation skills between 2nd and 3rd year medical students.