IMPACT OF CLINICAL SKILL LAB ON STUDENTS’ LEARNING IN PRECLINICAL YEARS
Abstract
Background: As 1st year students have no prior training in handling and facing patients, Clinical SkillLab (CSL) is the most suitable place to avoid direct doctor/patient interaction. The objective of this studywas to evaluate the performance of recently established CSL and its impact on student learning in basicscience subjects. Methodology: This study was carried out at the Departments of Physiology andMedical Education, Foundation University Medical College Islamabad, from January to October 2012.In this observational study, 150 of 1st year students were divided into 5 batches. Each batch attendedclinical skill lab once a week. Each batch was subdivided into 6 batches of 5 students each to befacilitated by one postgraduate trainee from clinical subjects. Overall supervision was done by aconsultant of status of Assistant Professor qualified to teach Medicine, Surgery and/or Physiology.Sessions were conducted for 2 hours daily (6 days a week) in which after an initial briefing, studentswere taught the communication skills, clinical skills and art of history taking and physical examination.Clinical integration of various modules taught in 1st year, i.e., skin, muscle and skeletal system (SMS),upper limb and breast, immunity and haematology, respiratory and cardiovascular modules was donefrom January to October 2012. Methods of teaching involved large group interactive sessions, smallgroup interactive sessions, self-directed learning, tutorials, revision on computer and recordings ofsessions given to students on flashes. Multiple choice questions and observed structured clinicalexamination were the main assessment tools. Combined assessment of 2 consecutive modules was doneat the end of 2nd module making a total of 3 assessments for 1st year. Absentees were included in failuresin view of impact of end of modules examinations on overall final assessment. Results: More than 73%students passed examination of clinical skills securing more than 50% marks in each module. Overallimpact of CSL was also seen in the subjects of Anatomy and Physiology. Result of purely anatomy SMSand breast modules increased from 64% (year 2011 class) to 79% (year 2012 class). Result of purelyPhysiology modules (Immunity and Haematology) increased from 77% (year 2011 class) to 94% (year2012 class). Similarly Respiratory and Cardiovascular modules result improved from 68% to 90.5%.Conclusion: The performance of CSL in imparting clinical skills, communication skills, history takingand physical examination was satisfactory. The experience of integrating clinical teaching with basicsciences not only improved students’ clinical experience reflected by evaluation, but was also rewardingin improving the results of various modules related to anatomy and physiology.Keywords: Clinical skill lab, Module, Integration, Curriculum, Medical Education, Physiology teachingReferences
Hao J, Estrada J, Tropez-Sims S. The clinical skills laboratory: a
cost-effective venue for teaching clinical skills to third-year
medical students. Acad Med 2002;77(2):152.
Bradley P, Bligh J. One year’s experience with a clinical skills
resource centre. Med Educ 1999;33:114–20.
Bradley P, Postlethwaite K. Setting up a clinical skills learning
facility. Med Educ 2003;37(suppl 1):6–13.
Bradley P, Postlethwaite K. Setting up and running clinical skills
learning programmes. The Clinical Teacher 2004;1(2):53–8.
doi: 10.1111/j.1743-498X.2004.00039.x
Bradley P, Bligh J. Clinical skills centers: where are we going?
Med Educ 2005;39:649–50.
Virtual clinical skill lab. School of Nursing, Wesbrook Mall
Vancouver, BC Canada. 2007. https://www.elearning.nursing.ubc.ca/
Clinical lab bus. Centre for excellence in teaching and learning,
Robin Brook Centre, St. Bartholomew’s Hospital, London.
http://www.cetl.org.uk/learning/bus.html
Pakistan Medical and Dental Council, and Higher Education
Commission Islamabad: Curriculum of MBBS (Revised 2011).
Morgan R. Using clinical skills laboratories to promote theorypractice integration during first practice placement: an Irish
perspective. J Clin Nurs 2006;15(2):155–61.
Beck AH. Student JAMA. The Flexner Report and the
Standardization of American Medical Education. JAMA
;291(17):2139–40.
Peeraer G, Scherpbier AJ, Remmen R, De winter BY, Hendrickx
K, van Petegem P, et al. Clinical Skills Training in a Skills Lab
Compared with Skills Training in Internships: Comparison of
Skills Development Curricula. Educ Health (Abingdon)
;20(3):125.
Quadri KH, Rahim MF, Alam AY, Jaffery T, Zaidi Z, Iqbal M.
The structure and function of a new Clinical Skills and Medical
Informatics Laboratory (SCIL) in a developing country–a two year
institutional experience. J Pak Med Assoc 2008;58(11):612–5.
Schuwirth LW, van der Vleuten CP. Changing education,
changing assessment, changing research. Med
Educ 2004;38(8):805–12.
Harden RM, Gleeson FA. Assessment of clinical competence
using Objective structure Clinical Examination OSCE. Med Educ
;13(1):41–54.
Miller GE. Assessment of clinical skill/performance/assessment.
Acad Med 1990;65(9 suppl);63–7.
Widyandana G, Majoor A, Scherpbier A. Transfer of medical
students’ clinical skills learned in a clinical laboratory to the care
of real patients in the clinical setting: the challenges and
suggestions of students in a developing country. Educ Health
(Abingdon) 2010;23(3):339.
Dent AJ. Adding more to the pie: the expanding activities of the
clinical skills centre. J R Soc Med 2002;95(8):406–10.
Katherine B, Luci E, Jean K, Elango S, Zeryab S, Sydney S, Alison
S. Preliminary report with draft consensus statements and
recommendations for performance assessment themes. 14th Annual
Ottawa Conference held at Miami, USA 2010; p. 1–12.
Shahid Hassan. Teaching and learning clinical skills at clinical
skills centre in Medical Institution–Are we denying our students
this effective skill lab method in developing countries. Pak J
Otolaryngol 2007;23:54–5.
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