A quasi-experimental study to compare the acquisition of basic clinical skills in novice medical students taught by George and Doto’s five-step method compared to those taught by the traditional approach (SODOTO)

Objectives: The aim of this study was to compare the acquisition of basic clinical skills by George and Doto’s five step method compared to the Traditional SODOTO approach, and to ascertain the perception of the students regarding these diverse methods. Materials and Methods: Fifty-four 2nd MBBS 1st semester students posted in the Department of Medicine at GMERS, Gotri, were enrolled for the study. After teaching the theory, both groups were taught per abdomen (P/A) examination and respiratory system (R/S) examination – one system by the five-step method and the other by the SODOTO approach. Skill acquisition was tested by pre-validated checklists. Finally, feedback was collected on the perception of students using a pre-validated questionnaire. The data were analysed using GraphPad. Results: There was an average 20% improvement (P < 0.001) in the group taught by the five-step method compared to the one taught by the traditional approach (P/A – 45.14/60 [5.64] vs. 57.86/60 [1.83] [Group B vs. Group A]) (R/S examination – 26.17/40 [6.65] vs. 34.79/40 [3.56] [Group A vs. Group B]). Conclusion: George and Doto’s five-step method has been found to be more effective than the traditional SODOTO approach.

The thinking of teaching“basic clinical skills”course to order-oriented medical students / 中华医学教育探索杂志

Based on the minimum basic requirements of global medical education (GMER), and taking example of training experience of domestic and foreign medical students' learning clinical skills , we have made a detailed analysis of the backgrounds , necessity and feasibility of opening course clinical basic skills to the order-oriented medical students in Chongqing. We have also put for-ward some countermeasures and suggestions to ensure the quality of teaching , so as to promote the course smoothly.

Examination of Training Methods for Basic Clinical Skills Before Bedside Learning: Comparison Between Fixed-Instructor and Rotation Systems / 医学教育

To evaluate training methods for basic clinical skills before bedside learning, we used questionnaires to ask students and instructors their opinions about the fixed-instructor system, in which one instructor teaches the entire course, and the rotation system, in which instructors share responsibilities for teaching according to their specialty. Students had positive impressions of training with both systems. Many students felt that communication with in structors was good inthe fixed-instructor system and that the specialized education provided by multiple instructors was good in the rotation system. However, students expressed dissatisfaction about differences in educational content between the systems. Instructors believed an advantage of the fixed-instructor system was that skills learned could be applied to all medical fields, whereas the rotation system made teaching easier because it was specialized. On the basis of this investigation, we conclude that training should establish good communication between instructors and students and should include the required educational contents. We also found that unifying educational contents is difficult, regardless of the training system. Few reports about educational methods used to teach basic clinical skills have been published in Japan, but studies focusing on this issue are becoming increasingly necessary.

Utility and Usefulness of the Skills Laboratory to Improve Practical Training in Clinical Skills / 医学教育

Medical students at Kurume University begin practical training in clinical skills in their fourth year. At that time, students use the skills laboratory to improve their clinical skills. Medical education resources in the skills laboratory include simulators for emergency resuscitation and heart diseases, wireless stethoscopes, and videotapes. All students use the skills laboratory for 2 months, and its usefulness was evaluated with questionnaires after practical training. More than 50 % of students approved of their practice in the skills laboratory. However, some students were unsatisfied because they were unable to make effective use of the simulators. In the future, an improved skills laboratory will be necessary to improve practical training in the clinical skills for medical students.

Evaluations of a Program for Teaching Basic Clinical Skills to Medical Students / 医学教育

A program for teaching basic clinical skills to fifth-year medical students was started at Toyama Medical and Pharmaceutical University in 1999. The five units of basic clinical skills included: 1) medical interviewing, 2) general physical examination, 3) chest examination, 4) abdominal examination, and 5) neurologic examination. The educational strategies and evaluations in each unit consisted of: 1) lectures, 2) videotape demonstrations, 3) role-playing in small groups, 4) practice on patients in small groups, 5) written examinations, and 6) objective structured clinical examinations. The students evaluated each session of the program with a five-grade rating scale and comments. Small-group sessions (role play and practice on patients) and objective structured clinical examinations received the highest scores, followed by videotape demonstrations. Lectures received significantly lower scores than did other parts of the program. In addition, most students recommended standardization of educational content, increased practice time, and fewer lectures. We conclude that evaluation by students is essential for improving programs for teaching basic clinical skills.

A Curriculum on the Undergraduate Education of General Medicine / 医学教育

The working group on the education of general medicine, Japan Society for Medical Education, has defined general medicine as a discipline which includes following three areas; 1) basic clinical skills which incorporate humane health care, 2) comprehensive community and family medicine and 3) general internal medicine which provides integrated services to solve clinical problems at any level. It has also issued a proposal on undergraduate education of general medicine at university hospitals. The working group now propose a detailed sample curriculum which describes the instruction in three areas mentioned above. Overview, General Instructional Objective (GTO), Specific Behavioral Objectives (SBOs), Learning Strategies (LS) and Evaluation are included in this sequence.

A Diagnostic Practice. The introduction of speciality-based physical examination / 医学教育

To improve physical examination skills of medical students, our original system of specialty-based physical examination (SBPE) was introduced into the diagnostic medical practice for 4th-year students. SBPE consisted of clinical practice and tests of every part of the physical examination which were administered and judged by each specialist, thereby greatly reducing the doctors' burden compared with a nonspecialist system. Because of the difficulty of preparing enough simulated or standardized patients, the medical interview was omitted from the system. Instead, the medical interview was directed stepwise according to a separate curriculum. Thus, these characteristics made SBPE much more practical to introduce. Results with this SBPE and those with a previous non-SBPE system were compared; the SBPE succeeded in reducing the number of “poor” grades and increasing the number of “good” grades on the test. These results demonstrate that SBPE is clinically efficacious because specialists could make an accurate evaluation and because the introduction of SBPE strongly motivated students.