Development and evaluation of an interactive multimedia clinical skills teaching program designed for the pediatric clerkship.

BACKGROUND AND PURPOSE: We evaluated the physical-examination section of a multimedia program developed to teach infant history and physical-examination skills. METHODS: A total of 71 students participated: one group viewed only the physical-examination section (PX), one the history section (HX), one none of the program (CX). We assessed physical-examination skills by direct observation of medical students performing an abdominal exam and scored using a checklist at baseline, immediately after intervention, and at the end of the pediatric clerkship. We analyzed results using analysis of variance with repeated measures. RESULTS: Baseline scores were PX = 2.5, HX = 2.8. The PX group scored significantly higher immediately postintervention at 6.8 compared to the HX group (3.1). At the end of the clerkship, significant differences between the groups remained. Final group mean scores were PX = 5.5, HX = 4.4, and CX = 2.7. CONCLUSION: The program improved examination skills with attenuation over 6 weeks.

Improving the interviewing and self-assessment skills of medical students: is it time to readopt videotaping as an educational tool?

PURPOSE: To evaluate the effect of a videotaping program on third-year medical students' interviewing and self-assessment skills. METHODS: A self-assessment manual, listing and explaining 21 core elements of the medical interview, was developed. After reading the manual, students videotaped an interview and self-assessed their performances. Each student reviewed the videotape with a faculty member who also rated the performance. This process was repeated 1 week later. Changes in group performance, core element performance, and ability to self-assess after the intervention were evaluated by Cohen d values to measure effect size, McNemar chi-square test for repeated measures, and concordance between faculty and student ratings. RESULTS: Sixty students participated in the videotaping study. Students inaccurately self-assessed on the first video 14% of the time. The 6 poorest-performed core elements were the least accurately self-assessed. Lack of concordance between the global rating given by faculty and student identified all students with inflated self-assessment. One review session had a large effect on overall performance and interpersonal skills and a moderate effect on history-taking skills. A large effect on performance was seen for 3 core elements, a moderate effect for 12 elements, and a small effect for the remaining 6 elements. Performance of the core elements that needed improvement did improve in 74% of the students (P <.001). Students' overall ability to self-assess improved significantly (P <.01). CONCLUSIONS: Our videotaping program improved students' interviewing and self-assessment skills and identified students with inflated views of their abilities. Medical educators should re-evaluate and readopt this excellent teaching and learning tool.