Back to the future: teaching medical students clinical procedures

Abstract

Over the last decade undergraduate training in clinical procedures has moved from ‘learning on patients' towards simulation-based training. Simulation was intended to be an adjunct rather than a replacement for experiential learning and several initiatives have emerged to redress this balance. With these initiatives in mind, we evaluated the impact of our undergraduate skills training programme and considered the need to change our teaching and learning strategy in this area.Outcomes-based data was accrued from the performance-based assessment of 64 medical students in four key procedures. Attitudinal data was gleaned from 130 responses to an electronic questionnaire and student self-efficacy ratings taken immediately before assessment. Students performed best in venepuncture. Performance in the other skills revealed 1 in 3 did not reach competence in IV cannulation and more than 1 in 2 were below standard when measuring a BM stix and priming an IV giving set. The data on self-efficacy and competence was analysed and a Spearman's Rank Correlation coefficient of 0.36 calculated. Students in final year were poor self-assessors and unaware that their skills often fell below standard. These results suggest a need to increase students' self-awareness and promote ward-based learning. This article considers how these objectives might be achieved.

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Additional information

Notes on contributors

Jeremy Morton

JEREMY MORTON is a fellow in Medical Education at the University of Edinburgh Medical School and an SpR in Anaesthesia, Critical Care and Pain Medicine.

Lisa Anderson

LISA ANDERSON, FIONA FRAME and JANETTE MOYES are all Clinical skills facilitators at the University of Edinburgh Medical School

Fiona Frame

LISA ANDERSON, FIONA FRAME and JANETTE MOYES are all Clinical skills facilitators at the University of Edinburgh Medical School

Janette Moyes

LISA ANDERSON, FIONA FRAME and JANETTE MOYES are all Clinical skills facilitators at the University of Edinburgh Medical School

Helen Cameron

HELEN S. CAMERON is the Director of the Medical Teaching Organization at the University of Edinburgh Medical School.