Boosting clinical performance: The impact of enhanced final year placements

Abstract

Background: This study follows on from a study that investigated how to develop effective final year medical student assistantship placements, using multidisciplinary clinical teams in planning and delivery.

Aims: This study assessed the effects on objective structured clinical examination (OSCE) performance of the in-course enhanced “super-assistantship” placement introduced to a randomly selected sample of 2013–14 final year medical students at Leeds medical school.

Methods: Quantitative data analysis was used to compare the global grades of OSCE stations between students who undertook this placement against those who did not.

Results: There was a small overall improvement in the “super-assistantship” student scores across the whole assessment (effect size = 0.085). “Pre-op Capacity”, “Admissions Prescribing” and “Hip Pain” stations had small-medium effect sizes (0.226, 0.215, and 0.214) in favor of the intervention group. Other stations had small effect sizes (0.107–0.191), mostly in favor of the intervention group.

Conclusions: The “super-assistantship” experience characterized by increasing student responsibility on placement can help to improve competence and confidence in clinical decision-making “in a simulated environment”. The clinical environment and multidisciplinary team must be ready and supported to provide these opportunities effectively. Further in-course opportunities for increasing final year student responsibility should be developed.

Acknowledgements

Many thanks to Vanessa Gray on the Leeds assessment team for preparation of the research data prior to analysis.

Disclosure statement

The authors report no declarations of interest.

Notes on contributors

Dougal Williams holds a BSc in Medical Education and is currently a medical student at the University of Leeds.

Anne-Marie Reid BDS EdD Med FHEA is currently Dean of Teaching & Learning and Reader in Medical Education at St George’s, University of London. She was formerly a Senior Lecturer at the University of Leeds, UK, where she researched the development of final year assistantship placements utilizing the tools of activity theory.

Matt Homer BSc, MSc, PhD, CStat is Associate Professor of Quantitative Methods and Assessment at the University of Leeds, working in both the Schools of Medicine and Education. His research generally has a quantitative methodological focus, and within medical education relates to evaluating and improving assessment quality, standard setting and psychometrics.