Clinical skills progress evaluation during internal medicine clerkships:
how much do students gain?
Abstract
Rationale, aims and objectives Clinical skills are important for medical
students and doctors for their everyday work and faculties are expected
to teach and assess clinical skills and other competencies that medical
students should have at the beginning of their career. Among
competencies required for a young doctor to begin with his or her career
are several clinical skills. The aim of our study was to evaluate in a
low-stakes formative assessment the clinical skills level improvement of
finishing medical students prior to and after their 9-week Internal
medicine clerkship. Method 88 final year medical students participated
in the study prior and after their 9-week Internal medicine clerkship.
On the first day and on their last day of clerkship, they were assessed
in three different clinical skills – history taking, venipuncture and
rectal examination. Clinical skills were performed on artificial
simulators (model of an arm and a prostate and rectal examination
simulator). Objective Structured Clinical Examination (OSCE) was used to
evaluate students. Assessors used a prepared checklist for each clinical
skill. Results A significant improvement was detected in total OSCE
(p=0.001), history taking (p=0.001) and rectal examination results
(p=0.023) on the second testing. Moreover, reduction of time needed to
complete the task was also detected in all clinical skills. Conclusion
Final year medical students have a lot of practical skills and are well
prepared for the clinical environment. They are prepared to perform
tested clinical skills on their own, without supervision. As there is
still room for improvement, additional activities should be considered
to improve performance in the clinical skill. In addition, there is less
evidence on assessment of clinical skills progress so further activities
should be considered.