Clinical skills in final-year medical students: the relationship between self-reported confidence and direct observation by faculty or residents

<p><b>INTRODUCTION</b>Many students, while performing clinical skills such as medical interviewing/ communication, physical examination, and procedural tasks, have never been observed by faculty members or residents. This study aimed to explore the relationships between final-year medical students' self-reported confidence and the frequency of direct observation by faculty member or resident while conducting these clinical skills.</p><p><b>MATERIALS AND METHODS</b>Medical students at China Medical University in Taiwan participated in the survey. Before graduating, they were asked to answer a questionnaire about (1) their confidence in performing 17 clinical skills including medical interviewing/communication, physical examination, and procedural tasks, and (2) the number of times they had been directly observed by faculty members or residents during student-patient encounters.</p><p><b>RESULTS</b>Many students reported never having been observed by a faculty member while they performed history taking/communication (46% to 84%), physical examination (36% to 42%), or procedural tasks (41% to 81%). It was found that residents had observed the students more frequently than the faculty members. The correlations between self-reported confidence and the corresponded direct observation were small to medium but significant. However, no difference was found between observation by a faculty member and by a resident.</p><p><b>CONCLUSIONS</b>This study confirmed that many medical students have not been directly observed in clinical training; and that those who were observed more often, expressed more self-reported confidence. Some assessment measures, which focus on direct observation and feedback during student-patient encounters, may improve the students' confidence.</p>

Cytochrome P450c17alpha (CYP17) gene polymorphism is not associated with leiomyoma susceptibility

Estrogen plays a role in the pathogenesis of leiomyoma. The CYP17 gene codes for the cytochrome P450c17alpha enzyme, which is involved in the biosynthesis of estrogen. Our aim was to investigate if CYP17 polymorphism could be a useful marker to predict the susceptibility to leiomyoma. Our sample of female subjects was divided into two groups: (1) with leiomyoma (n = 159); (2) without leiomyoma (n = 128). A 169-bp fragment encompassing the A1/A2 polymorphic site of the CYP17 gene was amplified by polymerase chain reaction (PCR), restricted by enzyme MspA1I and electrophored on agarose gel. Genotypes and allelic frequencies for this polymorphism in both groups were compared. There was no significant difference between the two groups regarding the distribution of the CYP17 gene polymorphism frequencies. The A1 homozygote/heterozygote/A2 homozygote proportions for CYP17 in both groups were: (1) 17.0/46.5/36.5 percent, and (2) 17.2/45.3/37.5 percent. The proportions for alleles A1 and A2 were also comparable in the two groups. A1 and A2 allele frequencies were: 7 percent (40.3/59) in group 1, and 2 percent (39.8/60) in group 2. No significant association was observed between the risk of leiomyoma and polymorphisms of the CYP 17 gene. So, CYP17 gene polymorphism does not appear to be a useful marker for the prediction of leiomyoma susceptibility