scholarly journals Temporal changes in medical student perceptions of their clinical skills and needs using a repeated self-assessment instrument

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Patrick Barlow ◽  
Robert Humble ◽  
Amal Shibli-Rahhal
Keyword(s):  
Differential Diagnosis ◽  
Medical Student ◽  
Communication Skills ◽  
Clinical Skills ◽  
Clinical Skill ◽  
Perceived Competence ◽  
Clinical Rotation ◽  
Self Assessment ◽  
Clinical Rotations ◽  
Over Time

Abstract Background Medical student needs in clinical skill training may change over time, but data on this topic are limited. This study uses repeated self-assessments on clinical rotations during medical school to evaluate students’ perceptions of their clinical skill growth. Methods A self-assessment rating was completed by students during each clinical rotation as they progressed through their core clinical rotation year. The instrument consisted of questions on 5 clinical skill categories where students rated their performance as “below”, “at” or “above” expected, and open-ended questions on strengths and challenges. We evaluated changes in self-ratings between the first (n=136) and third (n=118) quarters by matched-pair analysis of the shift in responses between time points using a Sign Test. We also identified the main themes from the students’ responses to open-ended questions. Results We found 22.4 % and 13.3 % of students increased their self-assessment ratings on “Oral Presentation Skills” and on “Differential Diagnosis”, respectively. In contrast, perceived ability to communicate with patients saw the largest negative shifts. “Patient Interaction” was the most commonly identified area of strength and “Knowledge and Organization” was most frequently cited as a barrier. Conclusions Students demonstrated a positive shift in perceived competence in some core clinical skills that are not strongly emphasized in the preclinical curriculum, likely reflecting increased exposure over time. However, their perceived competence in communication skills declined. This may reflect initial over-estimation or true decline due to competing needs/interests. These patterns of change can inform the design of longitudinal curricula that anticipate and address students’ needs during clinical rotations, such as placing increased emphasis on presentation skills and differential diagnosis earlier in the curriculum, and adding more emphasis to communication skills in later phases.

scholarly journals Teaching Pediatric Otoscopy Skills to the Medical Student in the Clinical Setting: Preceptor Perspectives and Practice

2020 ◽  
Author(s):  
Caroline Rose Paul ◽  
Alanna Higgins Joyce ◽  
Gary Beck Dallaghan ◽  
Meg Keeley ◽  
Corinne Lehmann ◽  
...  
Keyword(s):  
Medical Student ◽  
Medical Students ◽  
Online Survey ◽  
Clinical Teaching ◽  
Clinical Skills ◽  
Clinical Skill ◽  
Acute Otitis Media ◽  
The United States ◽  
Direct Patient Care ◽  
Barriers To Teaching

Abstract Background Acute otitis media (AOM) is the most frequent indication for antibiotic treatment of children in the United States. Its diagnosis relies on visualization of the tympanic membrane, a clinical skill acquired through a deliberate approach. Instruction in pediatric otoscopy begins in medical school. Medical students receive their primary experience with pediatric otoscopy during the required pediatric clerkship, traditionally relying on an immersion, apprentice-type learning model. A better understanding of their preceptors’ clinical and teaching practices could lead to improved skill acquisition. This study investigates how pediatric preceptors (PP) and members of the Council on Medical Student Education in Pediatrics (COMSEP) perceive teaching otoscopy. Methods A 30-item online survey was administered to a purposeful sample of PP at six institutions in 2017. A comparable 23-item survey was administered to members through the 2018 COMSEP Annual Survey. Only COMSEP members who identified themselves as teaching otoscopy to medical students were asked to complete the otoscopy-related questions on the survey. Results Survey respondents included 58% of PP (180/310) and 44% (152/348) of COMSEP members. Forty-one percent (62/152) of COMSEP member respondents identified themselves as teaching otoscopy and completed the otoscopy-related questions. The majority agreed that standardized curricula are needed (PP 78%, COMSEP members 97%) and that all graduating medical students should be able to perform pediatric otoscopy (PP 95%, COMSEP members 79%). Most respondents reported usefulness of the American Academy of Pediatrics (AAP) AOM guidelines (PP 95%, COMSEP members 100%). More COMSEP members than PP adhered to the AAP’s diagnostic criteria (pediatric preceptors 42%, COMSEP members 93%). The most common barriers to teaching otoscopy were a lack of assistive technology (PP 77%, COMSEP members 56%), presence of cerumen (PP 58%, COMSEP members 60%), time to teach in direct patient care (PP 46%, COMSEP members 48%), and parent anxiety (PP 62%, COMSEP members 54%). Conclusions Our study identified systemic and individual practice patterns and barriers to teaching pediatric otoscopy. These results can inform education leaders in supporting and enabling preceptors in their clinical teaching. This approach can be adapted to ensure graduating medical students obtain intended core clinical skills.

scholarly journals Teaching pediatric otoscopy skills to the medical student in the clinical setting: preceptor perspectives and practice

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Caroline R. Paul ◽  
Alanna D. Higgins Joyce ◽  
Gary L. Beck Dallaghan ◽  
Meg G. Keeley ◽  
Corinne Lehmann ◽  
...  
Keyword(s):  
Medical Student ◽  
Medical Students ◽  
Online Survey ◽  
Clinical Teaching ◽  
Clinical Skills ◽  
Clinical Skill ◽  
Acute Otitis Media ◽  
The United States ◽  
Direct Patient Care ◽  
Barriers To Teaching

Abstract Background Acute otitis media (AOM) is the most frequent indication for antibiotic treatment of children in the United States. Its diagnosis relies on visualization of the tympanic membrane, a clinical skill acquired through a deliberate approach. Instruction in pediatric otoscopy begins in medical school. Medical students receive their primary experience with pediatric otoscopy during the required pediatric clerkship, traditionally relying on an immersion, apprentice-type learning model. A better understanding of their preceptors’ clinical and teaching practices could lead to improved skill acquisition. This study investigates how pediatric preceptors (PP) and members of the Council on Medical Student Education in Pediatrics (COMSEP) perceive teaching otoscopy. Methods A 30-item online survey was administered to a purposeful sample of PP at six institutions in 2017. A comparable 23-item survey was administered to members through the 2018 COMSEP Annual Survey. Only COMSEP members who identified themselves as teaching otoscopy to medical students were asked to complete the otoscopy-related questions on the survey. Results Survey respondents included 58% of PP (180/310) and 44% (152/348) of COMSEP members. Forty-one percent (62/152) of COMSEP member respondents identified themselves as teaching otoscopy and completed the otoscopy-related questions. The majority agreed that standardized curricula are needed (PP 78%, COMSEP members 97%) and that all graduating medical students should be able to perform pediatric otoscopy (PP 95%, COMSEP members 79%). Most respondents reported usefulness of the American Academy of Pediatrics (AAP) AOM guidelines (PP 95%, COMSEP members 100%). More COMSEP members than PP adhered to the AAP’s diagnostic criteria (pediatric preceptors 42%, COMSEP members 93%). The most common barriers to teaching otoscopy were a lack of assistive technology (PP 77%, COMSEP members 56%), presence of cerumen (PP 58%, COMSEP members 60%), time to teach in direct patient care (PP 46%, COMSEP members 48%), and parent anxiety (PP 62%, COMSEP members 54%). Conclusions Our study identified systemic and individual practice patterns and barriers to teaching pediatric otoscopy. These results can inform education leaders in supporting and enabling preceptors in their clinical teaching. This approach can be adapted to ensure graduating medical students obtain intended core clinical skills.

scholarly journals Current Trends in Removable Partial Prosthodontics Teaching in Undergraduate Dental Colleges of Sindh, Pakistan

2021 ◽  
pp. 49-58
Author(s):  
Muneeb Ahmed Lone ◽  
Ahsan Inayat ◽  
Maham Muneeb Lone ◽  
Mohid Abrar Lone ◽  
Bharat Kumar ◽  
...  
Keyword(s):  
Clinical Skills ◽  
Cross Sectional Study ◽  
Dental Students ◽  
Clinical Rotation ◽  
Cross Sectional ◽  
Clinical Rotations ◽  
Current Trends ◽  
Minimum Number ◽  
Dental Schools ◽  
Partially Dentate

Objective: To explore current trends in removable partial prosthodontics teaching in undergraduate dental colleges of Sindh, Pakistan. Study Design: Descriptive Cross-sectional. Place and Duration of the Study: Department of prosthodontics in dental colleges of Sindh in September 2019. Methodology:  A descriptive cross-sectional study was done in which a questionnaire was sent by email to head of Prosthodontics department of 16 dental institutes of Sindh, Pakistan. The survey included different questions regarding current trends in removable partial prosthodontics education in undergraduate dental colleges. Results: Out of sixteen questionnaires, fourteen were completely filled and returned. Majority (69.2%) of the institutes teach fabrication of removable partial dentures (RPDs) in third year of dental college. Students of only one dental college fabricate 10-12 RPDs in their clinical rotation. All dental colleges teach acrylic RPD construction in their preclinical years. Faculty in 12 (85.7%) dental colleges always give clinical demonstrations to students before their clinical rotations. Eleven out of the fourteen colleges teach cast partial dentures (CPDs) theoretically, but no CPDs are fabricated by the students during their clinical rotation. About 70% dental schools do not have in-house facility to fabricate cast partial dentures. Conclusion: This study describes current trends of removable prosthodontics teaching in undergraduate colleges of Sindh. A large majority of undergraduate dental students are not fabricating the minimum number of partial dentures as per PMC requirement. Although theoretically cast partial dentures are taught in lectures but students do not construct them in their undergraduate years. Efforts should therefore be made to improve teaching practices and clinical skills of undergraduates, for them to be able to treat partially dentate patients after graduation.

scholarly journals Student’s Self-Assessment Regarding the Clinical Skills in Forensic Medicine

2020 ◽  
Vol 2 (2) ◽  
pp. 241-247
Author(s):  
Taufik Suryadi ◽  
Kulsum Kulsum
Keyword(s):  
Medical Students ◽  
Forensic Medicine ◽  
Learning Process ◽  
Evaluation System ◽  
Clinical Skills ◽  
Clinical Rotation ◽  
Preliminary Survey ◽  
Questionnaire Data ◽  
Self Assessment ◽  
Banda Aceh

In the learning process in forensic medicine clinical rotation, a measurable and standardized evaluation system is needed. The preliminary survey is undertaken to assess the ability of the student in clinical skills in rotation of forensic medicine. This survey was carry out in the Faculty of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia. The instrument used in this study was a questionnaire. Data was analyzed is done manually. As many as 81 medical students were included in the survey (20 male and 61 female). The average student score is based on survey 3.40, while the average academic value was given by the lecturer is 3.49. The survey was invalid with sensitivity 0.519, and specificity 0.593 (value<0,6). In this survey, found the validity of student self-assessment not valid in determining the ability of clinical skills, it is influenced by several factors of objectivity and subjectivity of assessment both in terms of students and lecturers. In general, student’s clinical skills in accordance with the achievement of competency in clinical rotation of forensic medicine.

scholarly journals How Do Students Self-assess: Comparing Student Self-assessment to Faculty and Resident Evaluations in Clerkship Rotations

2021 ◽  
Author(s):  
Anthony J. Gaynier ◽  
Jason Booza ◽  
Diane L. Levine
Keyword(s):  
Medical Student ◽  
Medical Students ◽  
State University ◽  
Self Assessment ◽  
Wayne State University ◽  
School Of Medicine ◽  
Self Assessments ◽  
Over Time

Abstract Background: The literature suggests that medical student self-assessment often does not match the evaluations from faculty/residents but can improve over time and with practice. Additionally, there is literature that suggests women underestimate their abilities compared with their male counterparts. Results: Medical students at Wayne State University School of Medicine (WSUSOM) completed self-assessments using the same 11 competencies that they are evaluated by faculty/residents (evaluators). All students completed self-assessments. Overall medical students significantly overestimated their performance in all competencies compared with evaluators. Women assessed their ability underestimated their performance in 33% of competencies. Conclusion: Improving self-assessment may improve students’ abilities to become self-regulated life-long learners.

Introduction

2012 ◽  
Author(s):  
Rupa Bessant
Keyword(s):  
Communication Skills ◽  
Royal College ◽  
Clinical Skills ◽  
Clinical Skill ◽  
Clinical Communication ◽  
The United Kingdom ◽  
Wide Range ◽  
Competency Based ◽  
Joint Examination ◽  
Royal Charter

The Royal College of Physicians was founded by royal charter of King Henry VIII in 1518. For nearly 500 years it has engaged in a wide range of activities dedicated to its overall aim of upholding and improving standards of medical practice. The examination for the Membership of the Royal College of Physicians (MRCP) (London) was first set in 1859. The Royal College of Physicians (Edinburgh) and the Faculty of Physicians and Surgeons of Glasgow introduced their own professional examinations in 1881 and 1886 respectively. A need to have a unified membership examination throughout the United Kingdom (UK) was identified in the late 1960s, following which the first joint examination took place in October 1968. The MRCP(UK) subsequently developed into the current internationally recognized three-part examination. From 2001, the five-station PACES (Practical Assessment of Clinical Examination Skills) examination was introduced, replacing the traditional long case, short cases and viva format. The rationale for this change was to standardize the candidate experience, to permit direct observation of candidate–patient interaction throughout the examination, and to place added emphasis on the assessment of communication skills. The MRCP(UK) format evolved further in 2009. In response to the development of competency-based training and assessment, the key components of the examination were redefined as seven ‘core clinical skills’: A) Physical examination B) Identifying physical signs C) Clinical communication skills D) Differential diagnosis E) Clinical judgement F) Managing patients’ concerns G) Maintaining patient welfare. Each ‘core clinical skill’ is assessed at several different stations of the PACES examination and the marks for each ‘skill’ are integrated. A minimum pass mark for each ‘core clinical skill’ was introduced to ensure that candidates who scored poorly in one ‘core clinical skill’ area could not pass the examination by scoring highly in another skill (a compensatory marking system had existed prior to 2009). Furthermore, the requirement to obtain a minimum overall test score has been maintained. At the time of writing this book, a score of 130/172 was required to pass.

scholarly journals Significance of experts' overall ratings for medical student competence in relation to history-taking

2006 ◽  
Vol 124 (2) ◽  
pp. 101-104 ◽  
Author(s):  
Luiz Ernesto de Almeida Troncon
Keyword(s):  
Medical Student ◽  
Communication Skills ◽  
Clinical Skills ◽  
Objective Structured Clinical Examination ◽  
History Taking ◽  
Point Scale ◽  
High Stake ◽  
Overall Performance ◽  
De Medicina ◽  
Key Questions

CONTEXT AND OBJECTIVE: Overall ratings (ORs) of competence, given by expert physicians, are increasingly used in clinical skills assessments. Nevertheless, the influence of specific components of competence on ORs is incompletely understood. The aim here was to investigate whether ORs for medical student history-taking competence are influenced by performance relating to communication skills, completeness of questioning and asking contentdriven key questions. DESIGN AND SETTING: Descriptive, quantitative study at Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo. METHODS: Thirty-six medical students were examined in a 15-station high-stake objective structured clinical examination (OSCE). At four stations devoted to history-taking, examiners filled out checklists covering the components investigated and independently rated students’ overall performance using a five-point scale from 1 (poor) to 5 (excellent). Physician ratings were aggregated for each student. Nonparametric correlations were made between ORs. RESULTS: ORs presented significant correlations with checklist scores (Spearman’s rs = 0.38; p = 0.02) and OSCE general results (rs = 0.52; p < 0.001). Scores for "communication skills" tended to correlate with ORs (rs = 0.31), but without reaching significance (p = 0.06). Neither the scores for "completeness" (rs = 0.26; p = 0.11) nor those for "asking key questions" (rs = 0.07; p = 0.60) correlated with ORs. CONCLUSIONS: Experts’ overall ratings for medical student competence regarding history-taking is likely to encompass a particular dimension, since ratings were only weakly influenced by specific components of performance.

scholarly journals Teaching Pediatric Otoscopy Skills to the Medical Student in the Clinical Setting: Preceptor Perspectives and Practice

2020 ◽  
Author(s):  
Caroline R Paul ◽  
Alanna Higgins Joyce ◽  
Gary Beck Dallaghan ◽  
Meg Keeley ◽  
Corinne Lehmann ◽  
...  
Keyword(s):  
Medical Student ◽  
Medical Students ◽  
Online Survey ◽  
Clinical Teaching ◽  
Clinical Skills ◽  
Clinical Skill ◽  
Acute Otitis Media ◽  
The United States ◽  
Direct Patient Care ◽  
Barriers To Teaching

Abstract Background: Acute otitis media (AOM) is the most frequent indication for antibiotic treatment of children in the United States. Its diagnosis relies on visualization of the tympanic membrane, a clinical skill acquired through a deliberate approach. Instruction in pediatric otoscopy begins in medical school. Medical students receive their primary experience with pediatric otoscopy during the required pediatric clerkship, traditionally relying on an immersion, apprentice-type learning model. A better understanding of their preceptors’ clinical and teaching practices could lead to improved skill acquisition. This study investigates how pediatric preceptors (PP) and members of the Council on Medical Student Education in Pediatrics (COMSEP) perceive teaching otoscopy. Methods: A 30-item online survey was administered to a purposeful sample of PP at six institutions in 2017. A comparable 23-item survey was administered to members through the 2018 COMSEP Annual Survey. Only COMSEP members who identified themselves as teaching otoscopy to medical students were asked to complete the otoscopy-related questions on the survey. Results: Survey respondents included 58% of PP (180/310) and 44% (152/348) of COMSEP members. Forty-one percent (62/152) of COMSEP member respondents identified themselves as teaching otoscopy and completed the otoscopy-related questions. The majority agreed that standardized curricula are needed (PP 78%, COMSEP members 97%) and that all graduating medical students should be able to perform pediatric otoscopy (PP 95%, COMSEP members 79%). Most respondents reported usefulness of the American Academy of Pediatrics (AAP) AOM guidelines (PP 95%, COMSEP members 100%). More COMSEP members than PP adhered to the AAP’s diagnostic criteria (pediatric preceptors 42%, COMSEP members 93%). The most common barriers to teaching otoscopy were a lack of assistive technology (PP 77%, COMSEP members 56%), presence of cerumen (PP 58%, COMSEP members 60%), time to teach in direct patient care (PP 46%, COMSEP members 48%), and parent anxiety (PP 62%, COMSEP members 54%). Conclusions: Our study identified systemic and individual practice patterns and barriers to teaching pediatric otoscopy. These results can inform education leaders in supporting and enabling preceptors in their clinical teaching. This approach can be adapted to ensure graduating medical students obtain intended core clinical skills.

scholarly journals Motion Smoothness Metrics for Cannulation Skill Assessment: What Factors Matter?

2021 ◽  
Vol 8 ◽  
Author(s):  
Simar Singh ◽  
Joe Bible ◽  
Zhanhe Liu ◽  
Ziyang Zhang ◽  
Ravikiran Singapogu
Keyword(s):  
Medical Training ◽  
Clinical Skills ◽  
Clinical Skill ◽  
Skill Assessment ◽  
Sensor Data ◽  
Task Completion ◽  
Global Rating ◽  
Self Assessment ◽  
Av Fistula ◽  
Objective Outcome

Medical training simulators have the potential to provide remote and automated assessment of skill vital for medical training. Consequently, there is a need to develop “smart” training devices with robust metrics that can quantify clinical skills for effective training and self-assessment. Recently, metrics that quantify motion smoothness such as log dimensionless jerk (LDLJ) and spectral arc length (SPARC) are increasingly being applied in medical simulators. However, two key questions remain about the efficacy of such metrics: how do these metrics relate to clinical skill, and how to best compute these metrics from sensor data and relate them with similar metrics? This study addresses these questions in the context of hemodialysis cannulation by enrolling 52 clinicians who performed cannulation in a simulated arteriovenous (AV) fistula. For clinical skill, results demonstrate that the objective outcome metric flash ratio (FR), developed to measure the quality of task completion, outperformed traditional skill indicator metrics (years of experience and global rating sheet scores). For computing motion smoothness metrics for skill assessment, we observed that the lowest amount of smoothing could result in unreliable metrics. Furthermore, the relative efficacy of motion smoothness metrics when compared with other process metrics in correlating with skill was similar for FR, the most accurate measure of skill. These results provide guidance for the computation and use of motion-based metrics for clinical skill assessment, including utilizing objective outcome metrics as ideal measures for quantifying skill.

Outcomes: Promoting Reflective Practice Using Performance Indicator Questionnaires

2010 ◽  
Vol 20 (2) ◽  
pp. 64-70 ◽  
Author(s):  
Mary Pat McCarthy
Keyword(s):  
Clinical Education ◽  
Performance Indicator ◽  
Clinical Skills ◽  
Self Assessment ◽  
Clinical Practicum ◽  
Self Reflection ◽  
Healthcare Settings ◽  
Language Pathology ◽  
Traditional Performance ◽  
The University

This article details the process of self-reflection applied to the use of traditional performance indicator questionnaires. The study followed eight speech-language pathology graduate students enrolled in clinical practicum in the university, school, and healthcare settings over a period of two semesters. Results indicated when reflection was focused on students' own clinical skills, modifications to practice were implemented. Results further concluded self-assessment using performance indicators paired with written reflections can be a viable form of instruction in clinical education.

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