Clinical Skills Laboratory Research Articles

Innovation of educational wound models for nursing students

Background: A clinical skills laboratory enhances nursing skills that can be translated to real professional practice. However, effective laboratory learning material that facilitates learners to achieve learning objectives may be inadequate in resource-limited settings. This study aimed to develop models for practicing wound dressing changes and to evaluate the quality of the model and user satisfaction. Methods: The study was conducted in three phases: 1) preparing for model development, 2) model development, and 3) evaluation of the quality of the model and user satisfaction. Convenience sampling was employed to recruit both recruited both nursing instructors and nursing students, 30, 10 and 271 participants in the first, second, and third phases, respectively. Focus group discussions were performed to gain ideas and opinions for developing the models. A Likert scale questionnaire was used to evaluate the quality of the model and user satisfaction. Results: The developed wound models were made from silicone. The quality evaluation form determined that the developed models had higher overall quality than those previous models available in nursing laboratory center. User satisfaction with the developed models was high. The overall mean (SD) of user satisfaction toward the developed closed-wound model and open-wound model were 3.41 (0.72) and 3.44 (0.71), respectively. Conclusions: The developed wound models are potentially useful and user friendly, and could be easily available in settings of education with limited resources. Encouraging the students to use these models may help to enhance self-directed learning and clinical skills for application of wound dressings.

Third-year medical students’ and clinical teachers’ perceptions of formative assessment feedback in the simulated clinical setting

Background. Clinical skills training in the clinical skills laboratory (CSL) environment forms an important part of the undergraduate medical curriculum. These skills are better demonstrated than described. A lack of direct observation and feedback given to medical students performing these skills has been reported. Without feedback, errors are uncorrected, good performance is not reinforced and clinical competence is minimally achieved. Objectives. To explore the perceptions of 3rd-year medical students and their clinical teachers about formative clinical assessment feedback in the CSL setting. Methods. Questionnaires with open- and closed-ended questions were administered to 3rd-year medical students and their clinical skills teachers. Quantitative data were statistically analysed while qualitative data were thematically analysed. Results . Five clinical teachers and 183 medical students participated. Average scores for the items varied between 1.87 and 5.00 (1: negative to 5:positive). The majority of students reported that feedback informed them of their competence level and learning needs, and motivated them to improve their skills and participation in patient-centred learning activities. Teachers believed that they provided sufficient and balanced feedback. Some students were concerned about the lack of standardised and structured assessment criteria and variation in teacher feedback. No statistical difference (p<0.05) was found between the mean item ratings based on demographic and academic background. Conclusion. Most teachers and students were satisfied with the feedback given and received, respectively. Structured and balanced criterion-referenced feedback processes, together with feedback training workshops for staff and students, are recommended to enhance feedback practice quality in the CSL. Limited clinical staff in the CSL was noted as a concern.

Development of an optional clinical skills laboratory for surgical skills training of veterinary students.

Development of an optional clinical skills laboratory for surgical skills training of veterinary students.

Effects of an optional clinical skills laboratory on surgical performance of third-year veterinary students.

To determine whether addition of an optional clinical skills laboratory (OCSL) to the traditional surgery curriculum would affect total surgery time or incision closure time in veterinary students performing ovariohysterectomy of a dog during a third-year surgery course. Retrospective and prospective study of veterinary student attendance at OCSL sessions and student performance during the third-year surgery course. Students from the classes of 2012, 2013, and 2014 at the Washington State University College of Veterinary Medicine. For all students, total surgery time and incision closure time were recorded when students performed an ovariohysterectomy of a dog during their third-year live-animal surgery course. Times were analyzed to identify differences among classes and determine whether times were associated with number of OCSL sessions attended, previous experience performing ovariohysterectomies, or enrollment in an elective clinical skills course. Total surgery and incision closure times were not significantly different between students in the class of 2012 (no access to the OCSL prior to the third-year surgery course) and students in the class of 2013 (ie, access to 4 OCSL sessions during the spring semester prior to the third-year surgery course). However, times were significantly shorter for students in the class of 2014 (ie, students who had access to OCSL sessions during the 3 semesters prior to the third-year surgery course) than for students in the other 2 classes. Results suggested that attendance in the OCSL sessions was associated with improvements in surgical performance, as reflected in faster total surgery and incision closure times while performing an ovariohysterectomy during the third-year surgery course.

South African–Cuban Medical Collaboration: students’ perceptions of training and perceived competence in clinical skills at a South African institution

Background: The South African–Cuban Medical Collaboration programme aims to alleviate the critical shortage of practitioners in local South African rural settings. The students who return from Cuban-based facilities in their fourth year experience difficulty, especially in clinical settings, upon joining the MB ChB final-year student programme at the University of KwaZulu-Natal. Attempts to support their skills acquisition for local practice have led to an investigation of their prior clinical skills exposures, the curricular context and exposures in Cuba in which skills had been acquired, and students’ perceptions of their competence in clinical skills.Methods: This descriptive, cross-sectional study explored the clinical experiences of the 2013 cohort of students. Qualitative and quantitative data were collected through questionnaires that explored the curricular approach and setting of clinical skills training in Cuba, the students’ exposure to clinical skills and their perceptions of their competence at performing these skills.Results: Students experienced the Cuban curriculum as didactic and lecture intensive as opposed to the systematic, problem-based curriculum offered in South Africa. Clinical training in Cuba occurs in hospital wards while local students first train in a clinical skills laboratory prior to hospital exposures. The majority of students self-reported a lack of clinical exposure to 35 of an overall 75 core-skills list as identified by the undergraduate UKZN curriculum. In addition, they reported an inability to perform 71 of the 75 (95%) skills independently.Conclusion: This study has highlighted a mismatch between the focus and scope of clinical training offered to students studying in Cuba and those at a South African institution.

Exploration of OSCE Results to Evaluate Medical Students’ Progress on Learning Eye Examination in Clinical Skills Laboratory

Background: Medical student learn how to perform eye examinations since beginning in clinical skills laboratory. Objective Structured Clinical Examination (OSCE) was used to assess students’ clinical skills performance every year and to indicate students’ progress. To evaluate medical students’ clinical skills progress, and to evaluate OSCE of eye examination skills. Methods: A cohort study, involving first and third year OSCE results in Clinical Skills Laboratory, Faculty of Medicine Gadjah Mada University from medical students batch 2010 (n:185). The scores of OSCE Year 1 compared to Year 3 using Mann whitney test to explore the progress of students clinical skills performance. To correlate between OSCE scores with clinical cases used in OSCE (such as: visual aquity, visual field, segment anterior and posterior examination) using Pearsoncorrelation to evaluate the assessment process. Result: OSCE results show that medical studens give significant progress on their eye examination performance (median OSCE year 1=66, year 3=80; p=0.00). There is strong correlation between clinical cases during OSCE with students score (p=0.005) that show inequality of difficulty level of cases, particularly for first year OSCE that used more detail check list instrument. Conclusion: Medical students show significant progress on their eye examination skills performance. OSCE process need to be improved, especially on developing clinical cases and check list as a scoring instrument. Keywords: medical students, eye examination, OSCE score

An exploratory qualitative analysis of student midwives views of teaching methods that could build their confidence to deliver perinatal bereavement care

Equipping student midwives with confidence to deliver bereavement care to childbearing women is a challenge for midwifery lecturers. To explore qualitative data provided by student midwives who evaluated the workbook Bereavement care for childbearing women and their families (Hollins Martin & Forrest, 2013) to explore their views of potential teaching strategies that could build their confidence to deliver real bereavement care. An exploratory qualitative thematic analysis was used to provide, analyse and report themes identified within data collected in a prior study. Participants were student midwives (n=179) in their second/third year of a midwifery degree program at 1 of 3 universities in the UK were included in the study. Data to evaluate effectiveness of the bereavement workbook as a teaching method was collected using a survey instrument. It was the comments written under questions by participants that were analysed in the present study. Three themes emerged: (1) increasing classroom interaction, (2) the importance of reflecting on emotions, and (3) need for experience. Although this study has addressed delivery of education that relates to midwives, the findings are cross transferable to other healthcare educators, practitioners, and students. Several solutions are proposed that could potentially build student confidence to deliver bereavement care: lecturers should (1) encourage group discussion in the classroom to help build student confidence to emotionally cope during real bereavement events; (2) ensure students gain exposure by encouraging qualified midwives to include them in real bereavement events early on in their training, and (3) develop packages of perinatal bereavement scenarios for simulation and rehearsal in the clinical skills laboratory. Post-implementation, it is recommended that these teaching strategies be evaluated.

La Iniciativa del Laboratorio de Habilidades Clínicas Veterinarias

<p>Los estudiantes de veterinaria necesitan desarrollar competencia en sus habilidades clínicas como preparación para el trabajo práctico. Los modelos y simuladores se utilizan cada vez más para ayudar a complementar la formación práctica existente y, a menudo, se alojan en laboratorios de habilidades clínicas. Este tipo de laboratorio ofrece un ambiente seguro donde los estudiantes pueden practicar varias veces en los modelos con el fin de desarrollar el dominio de las habilidades. También es un lugar ideal para realizar clases y evaluaciones prácticas, tales como los exámenes clínicos estructurados por objetivos (OSCE). La iniciativa del laboratorio de habilidades clínicas veterinarias es relativamente nueva y de crecimiento reciente, lo que ha sido facilitado por varios factores. Es mucho lo que se puede aprender de la educación médica y de otras profesiones de la salud, ya que sus laboratorios de habilidades clínicas llevan ya funcionando muchos años. Además, hay varias conferencias específicas de veterinaria que ahora incluyen sesiones dedicadas a las habilidades clínicas y tienen talleres donde, por ejemplo, los participantes pueden compartir consejos sobre la fabricación de modelos y discutir cómo desarrollar y gestionar estos laboratorios. Como complemento a las reuniones cara a cara, hay una próspera comunidad internacional, el grupo “Veterinary Clinical Skills & Simulation” en el foro en línea NOVICE (Network Of Veterinarians In Continuing Education), donde los miembros pueden hacer preguntas, obteniendo respuestas generalmente rápidas, compartir consejos y recopilar información útil. Recientemente, fruto de una colaboración internacional, se ha publicado una guía gratuita sobre los laboratorios de habilidades clínicas, la cual proporciona información clave para la creación de nuevos laboratorios o la ampliación de las instalaciones existentes. No cabe duda de que la iniciativa de las habilidades clínicas veterinarias seguirá creciendo y compartiendo experiencias, con los beneficios asociados para el aprendizaje del estudiante y el bienestar animal.</p>

Augmented reality m-learning to enhance nursing skills acquisition in the clinical skills laboratory

Purpose – This paper aims to report on a pilot research project designed to explore if new mobile augmented reality (AR) technologies have the potential to enhance the learning of clinical skills in the lab. Design/methodology/approach – An exploratory action-research-based pilot study was undertaken to explore an initial proof-of-concept design in using AR resources to supplement clinical skills lab teaching. A convenience non-probability sample of 72 undergraduate nursing students tested these resources during lab sessions, and participated in post-exposure surveys and focus groups to help evaluate them. This pilot design aimed to test logistics and gather information prior to further developmental work. Findings – Key similarities emerged between the survey and focus group findings regarding the technical issues and support for student learning. Students clearly expressed a comfort with the technology, and both students and faculty identified the ability to access resources to support self-directed learning and review of skills as positive attributes of using AR. However, technical issues such as slow response times and incompatible smartphones interfered with resource access and frustrated some students, potentially having a negative impact on their learning. Students gave positive feedback regarding the value of mobile access and having AR resources available “at the bedside” where they were practicing. Research limitations/implications – This empirical pilot study was limited to a small number of participants in a single location. However, a deeper understanding of the potential value of AR in clinical health professional education, and best practices in implementing these new technologies, was achieved. Practical implications – This study provides a valuable practical contribution, as the approach for AR resource development described can be readily replicated by teachers with limited technical skills. The practical limitations of AR technologies discovered by use in real-world settings will provide developers and educators with valuable information as they begin to explore the use of AR in the lab and beyond. Social implications – AR represents a rapidly developing field, with increasing social impact. This study provides some initial ideas that will help inform future uptake of AR in wider educational settings, beyond health professional education. Originality/value – This study represents original work in the field, and specifically, an original implementation of AR in an educational context.

The perspectives of final year medical students for one year training experience in clinical skills laboratory in Erbil

Background and objective: The aim of this study was to provide a general description of a new experience of introducing teaching in clinical skills laboratory to the final year students of Hawler College of Medicine and to assess the students’ perspectives of one year training experience in the newly established clinical skills laboratory. Methods: This study was based on a self-administered questionnaire survey of 79 final year medical students. The questionnaire included 31 statements related to the physical environment of the clinical skills laboratory, duration of clinical skills practice, quality of clinical skills teaching and usefulness of clinical skills laboratory. Each statement was rated on a five-point Likert scale. Results: Most students were satisfied with the location of the clinical skills laboratory (62.8%) and appropriateness of educational atmosphere of the laboratory (59%). Less than half of the students were satisfied with adequacy and appropriate use of educational equipments. Students had concerns about the short duration of clinical skills practice and unavailability of structured and well explained guidelines (36.7%). Majority of students indicated that they prefer to take sessions in the skills laboratory and practice before dealing with real patients (78.1%) and have earlier integration of teaching in clinical skills laboratory in the medical study curriculum (71.8%). Conclusion: This short and new experience of training in clinical skills laboratory was positively recognized in general. The study identified shortcomings in a number of aspects that need to be addressed to improve the experience.

Clinical skills Lab: A Need in Nepalese Medical School

Medicine of present world demands high level of competency in both clinical examination and performing a procedure in patients. The traditional methods of bedside skill learning and teaching should be supplemented by instruction in clinical skills lab of basic important clinical skills. Every medical school should work towards establishment and incorporation of clinical skills lab in basics science subjects and clinical posting along with other subjects to make it Practice oriented and Student centred learning.Journal of Patan Academy of Health Sciences. 2014 Jun;1(1):49-51

Instructional Strategies Used to Improve Students’ Comfort and Skill in Addressing the Occupational Therapy Process

The purpose of this study was to investigate the effectiveness of an intentional blending of instructional strategies in an occupational therapy (OT) entry-level master’s course. The OT Adult Practice course uses case-based instructional strategies, clinical skills labs, and standardized patient experiences in a dovetailed approach across three progressively complex clinical scenarios involving adult clients. The course is designed to support students in addressing the entire OT Process. Results of quantitative data analysis indicated that the sequential application of case-based instructional strategies, lab experiences, and standardized patient learning opportunities significantly improved students’ self-perception of their level of comfort and skill in being able to perform the following components of the OT process for adult clients: occupational profile, OT evaluation, developing an OT treatment plan, implementing OT treatment, and planning for discharge.

Qualitative case study data analysis: an example from practice.

To illustrate an approach to data analysis in qualitative case study methodology. There is often little detail in case study research about how data were analysed. However, it is important that comprehensive analysis procedures are used because there are often large sets of data from multiple sources of evidence. Furthermore, the ability to describe in detail how the analysis was conducted ensures rigour in reporting qualitative research. The research example used is a multiple case study that explored the role of the clinical skills laboratory in preparing students for the real world of practice. Data analysis was conducted using a framework guided by the four stages of analysis outlined by Morse ( 1994 ): comprehending, synthesising, theorising and recontextualising. The specific strategies for analysis in these stages centred on the work of Miles and Huberman ( 1994 ), which has been successfully used in case study research. The data were managed using NVivo software. Literature examining qualitative data analysis was reviewed and strategies illustrated by the case study example provided. Discussion Each stage of the analysis framework is described with illustration from the research example for the purpose of highlighting the benefits of a systematic approach to handling large data sets from multiple sources. By providing an example of how each stage of the analysis was conducted, it is hoped that researchers will be able to consider the benefits of such an approach to their own case study analysis. This paper illustrates specific strategies that can be employed when conducting data analysis in case study research and other qualitative research designs.

Nursing students' perceptions of factors influencing their learning environment in a clinical skills laboratory: A qualitative study

The mastery of clinical skills learning is required to become a trained nurse. Due to limited opportunities for clinical skills training in clinical practice, undergraduate training at clinical skills laboratories (CSLs) is an essential part of nursing education. In a sociocultural learning perspective learning is situated in an environment. Growing student cohorts, rapid introduction of technology-based teaching methods and a shift from a teaching- to a learning-centered education all influence the environment of the students. These changes also affect CSLs and therefore compel nursing faculties to adapt to the changing learning environment. This study aimed to explore students' perceptions of their learning environment in a clinical skills laboratory, and to increase the knowledge base for improving CSL learning conditions identifying the most important environmental factors according to the students. An exploratory qualitative methodology was used. Nineteen second-year students enrolled in an undergraduate nursing program in Norway participated in the study. They took the same clinical skills course. Eight were part-time students (group A) and 11 were full-time students (group B). Focus group interviews and content analysis were conducted to capture the students' perception of the CSL learning environment. The study documents students' experience of the physical (facilities, material equipment, learning tools, standard procedures), psychosocial (expectations, feedback, relations) and organizational (faculty resources, course structure) factors that affect the CSL learning environment. Creating an authentic environment, facilitating motivation, and providing resources for multiple methods and repetitions within clinical skills training are all important for improving CSL learning environments from the student perspective.

Walking the bridge: Nursing students' learning in clinical skill laboratories

Despite an increasing focus on simulation as a learning strategy in nursing education, there is limited evidence on the transfer of simulated skills into clinical practice. Therefore it's important to increase knowledge of how clinical skills laboratories (CSL) can optimize students' learning for development of professional knowledge and skills, necessary for quality nursing practice and for patient safety. Thus, the aim was to describe nursing students' experiences of learning in the CSL as a preparation for their clinical practice. Interviews with 16 students were analysed with content analysis. An overall theme was identified — walking the bridge — in which the CSL formed a bridge between the university and clinical settings, allowing students to integrate theory and practice and develop a reflective stance. The theme was based on categories: conditions for learning, strategies for learning, tension between learning in the skills laboratory and clinical settings, and development of professional and personal competence. The CSL prepared the students for clinical practice, but a negative tension between learning in CSL and clinical settings was experienced. However, this tension may create reflection. This provides a new perspective that can be used as a pedagogical approach to create opportunities for students to develop their critical thinking.

Use of simulators in operative dental education: experience in southern Nigeria.

Though the use of simulators in operative dentistry is not new, the teaching and learning practices that take place during clinical sessions in skills laboratories are rarely reported. This study was designed to determine the current practices relating to teaching and learning of dental clinical skills in southern Nigeria. A cross-sectional study was conducted among the final year dental students in southern Nigeria using anonymous structured questionnaire as instrument for data collection. The questionnaire items included statements relating to existing teaching and learning practices. A five-point Likert scale response option was provided and descriptive summary statistics was computed. There were 56 (34.8%) females and 105 (65.2%) males. Most of the students (41.0%) agreed that the theoretical concept behind clinical skills is taught prior to clinical sessions and most agreed that the objectives of each clinical session are stated and that the procedures are usually demonstrated. Most of the respondents (39.8%) agreed that feedback was sometimes embarrassing and given at the end of clinical sessions (76.6%). Equipment breakdown was a major challenge to learning. Dental education in the skills labs within the region appeared standard. However, feedback should be continuous and constructive. Equipment breakdown was the major constraint to learning.

The Effect of Web-based and Simulation-based Education on Midwifery Students’ Self-Confidence in Postpartum Hemorrhage Management

Background: Self-confidence, as one of the key elements of clinical competence, plays an important role in one’s actions and behaviours. Selection of proper instructional methods influences students’ self-confidence. Therefore, this study aimed to compare the effects of web-based training and educational simulation on midwifery students’ self-confidence in postpartum hemorrhage management. Methods: This experimental study was conducted on 44 midwifery students of Mashhad School of Nursing and Midwifery, Mashhad, Iran, in 2013. The subjects were selected via convenience sampling. The web-based group was trained at the clinical skill laboratory of School of Nursing and Midwifery; both groups were taught the same educational content. Data were collected using a demographic questionnaire, visual analogue scale to evaluate students' self-assessment of their ability to manage postpartum hemorrhage and C-scale to measure students' self-confidence Descriptive analysis, independent t-test, paired t-test, and two-way ANOVA were performed, using SPSS version 11.5. Results: Both groups showed a significant increase in self-confidence in postpartum hemorrhage management one month after the training (P=0.003 and P=0.030 in web-based and simulation groups, respectively). No significant difference was found between the two groups in terms of self-confidence in postpartum hemorrhage management. Conclusion: Since the two groups showed no significance difference in self-confidence, web-based education, which is a more accessible method, could be applied as an alternative to the conventional method of simulation.

Board #224 - Program Innovation Integration of Simulation Training throughout Undergraduate Medical Education (Submission #10053)

Objectives For more than 20 years, medical literature has increasingly documented the need for students to learn, practice, and demonstrate competence in basic clinical knowledge, assessment skills, and procedural skills. In 2001, the LSUHSC School of Medicine New Orleans replaced its traditional Introduction to the Clinical Medicine (ICM) course with the Science and Practice of Medicine (SPM) course. Curriculum innovations included changes to the lecture format, reduction in lecture hours, changes to the lab structure, additional small group instruction, and the incorporation of computer-based learning. One of the key adaptations to the new curriculum was the addition of simulation (role play, anatomical models, low-high fidelity simulators) in the Clinical Skills Lab and Human Patient Simulation Lab (HPS). Description The Clinical Skills Lab (CSL) is designed as an active learning approach that focuses on small group instruction, hands-on training, peer-to-peer observation, and immediate feedback in a non-stressful controlled environment. Procedural skill instruction at the level of first and second-year medical students permits reinforcement of basic science principles in clinical case scenarios. The CSL allows the preclinical students to learn, practice, and demonstrate competence in 40 basic skills over the 15 sessions. Third year students participate in the HPS Lab, and are required to manage patients that relate to their clerkship curriculum. Over the course of the year, students manage and treat eight simulated patients with a variety of illnesses which are listed below. In 2011, LSUHSC extended the use of simulation into the fourth year with a new course called Critical Concepts. This course was developed to ensure that students can recognize and manage core conditions that clinical departments believed necessary for all interns. This course currently has eight participating departments: Emergency Medicine, Pulmonary Critical Care, Pediatrics/NICU, Anesthesia, Obstetrics/Gynecology, Orthopedics, Psychiatry and Surgery. The table below shows the department and areas of instruction.Conclusion The SPM course allows freshman medical students the opportunity to supplement their history-taking skills with rudimentary physical assessment and procedure/skill acquisition. Second-year medical students are encouraged to solve more complex medical cases involving lab and physical exam abnormalities that require integration of previously acquired CSL skills. The Critical Concept course prepares students to enter residency with a more sophisticated understanding of the complexity of diseases and patient management. While all of these courses use various types of simulation training, they are not designed to replace real clinical patient experiences. They are designed to provide early exposure to clinical medicine, challenge students to apply their medial knowledge, enhance patient management skills, and provide the opportunity to practice skills/procedures in a patient-free environment. Disclosures None

Clinical skills of veterinary students - a cross-sectional study of the self-concept and exposure to skills training in Hannover, Germany.

BackgroundStudents of veterinary medicine should achieve basic professional competences required to practise their profession. A main focus of veterinary education is on developing clinical skills.The present study used the guidelines of the “Day-One Skills” list of European Association of Establishments for Veterinary Education (EAEVE) to create an online questionnaire for assessing the skills acquired by students at the University of Veterinary Medicine Hannover (TiHo). The theoretical and practical veterinary knowledge levels of the students and postgraduates are determined and compared.ResultsIn two batches, 607 people responded (response batch 1, 23.78%; response batch 2, 23.83%). From 49 defined skills, 28 are actually practised during training at the university and 21 activities are known only theoretically. Furthermore, the students showed great willingness to use simulators and models in a clinical skills lab.ConclusionsThe results of this survey highlight that the opening of a clinical skills lab at the University of Veterinary Medicine Hannover and its incorporation into the study programme are ideal tools to promote practical competences and foster the motivation to learn.Electronic supplementary materialThe online version of this article (doi:10.1186/s12917-014-0302-8) contains supplementary material, which is available to authorized users.

Pengaruh Pelatihan Caring terhadap Perilaku Memberikan Asuhan Keperawatan pada Mahasiswa Saat Rotasi Klinik di Politeknik Depkes Palangka Raya

Background: Evaluation and faculty development program for dental faculty at Muhammadiyah University of Yogyakarta are necessary to improve clinical teacher abilities in skills laboratory. The objective of this study is to conduct pilot study of training program on clinical skills laboratory instructors’ teaching abilities; to measure instructors’ teaching ability before and after the training; and to understand instructors’ perception on the given training.Method: This study was a pretest-posttest single group design accompanied with qualitative method. The subjects are 12 clinical teachers and 91 students of Dental School, Muhammadiyah University of Yogyakarta. Quantitative data analysis by measuring effect size. Focus group discussion conducted after quantitative data were collectedResult: (1) There were moderate effect of clinical skills laboratory teacher’s training program to communication and clinical teaching abilities (d> 0,50). (2) The qualitative analysis showed the good perception of participants and feasibility of teacher training program, the lack of teacher of teacher training program, and the advice to improve the quality of teacher training program. Conclusion: Training of skills-lab instructors was needed to improve communication and teaching ability among skills-lab instructors.