DOI QR코드

DOI QR Code

Educational Strategies for Clinical and Technical Skills Performance

진료와 술기 수행의 교육전략

  • Roh, HyeRin (Department of Medical Education, Inje University College of Medicine)
  • 노혜린 (인제대학교 의과대학 의학교육학교실)
  • Received : 2016.09.20
  • Accepted : 2016.10.24
  • Published : 2016.10.31

Abstract

The aim of this study is to provide the background of developing guides to clinical performance and basic clinical skills and to introduce how to teach and learn using the guide. The students' performance problems presented in an objective clinical skills examination were disease-centered tertiary hospital clinical care, incomplete performance, doing by rote, and an exam-oriented learning attitude. The problems were caused by a tertiary hospital-based educational environment as well as schools and faculty who are unfamiliar with the concept of patient-centered care. The purpose of the guide to clinical performance and basic clinical skills is to overcome these problems and address the causes. The guides show a clinical presentation approach to primary care; clinical care integrated with knowledge, skills, and attitude; a schematic approach; and a patient-centered attitude. To achieve these goals, a strategy to change the educational culture is important. Curricular reform, faculty development, and improving educational facilities and environments are suggested.

Keywords

References

  1. Aflatoonian, A., Baghianimoghadam, B., Abdoli, A., Partovi, P., Hemmati, P., Tabibnejad, N., & Harasym, P. (2012). Developing an educational scheme for undergraduate medical curriculum: The unit of "infertility" as a sample. J Med Life, 5(1), 16-20.
  2. Aspegren, K., & Lonberg-Madsen, P. (2005). Which basic communication skills in medicine are learnt spontaneously and which need to be taught and trained? Med Teach, 27(6), 539-543. https://doi.org/10.1080/01421590500136501
  3. Barrows, H. S. (1993). An overview of the uses of standardized patients for teaching and evaluating clinical skills. Acad Med, 68(6), 443-451. https://doi.org/10.1097/00001888-199306000-00002
  4. Blissett, S., Cavalcanti, R. B., & Sibbald, M. (2012). Should we teach using schemas?: Evidence from a randomised trial. Med Educ, 46(8), 815-822. https://doi.org/10.1111/j.1365-2923.2012.04311.x
  5. Cantrell, M., Heard, J. K., Lindsey, M., & Cleveland, E. (1997). Using standardized patients in the time-in/time-out interviewing technique. In A. J. J. A. Scherpbier, C. P. M. van der Vleuten, J. J. Rethans, & A. F. W. van der Steeg (Eds.), Advances in medical education (pp. 700-702). Netherlands: Springer.
  6. Eva, K. W. (2005). What every teacher needs to know about clinical reasoning. Med Educ, 39(1), 98-106. https://doi.org/10.1111/j.1365-2929.2004.01972.x
  7. Haring, C. M., Cools, B. M., van der Meer, J. W., & Postma, C. T. (2014). Student performance of the general physical examination in internal medicine: An observational study. BMC Med Educ, 14, 73. https://doi.org/10.1186/1472-6920-14-73
  8. Hauer, K. E., Teherani, A., Kerr, K. M., O'Sullivan, P. S., & Irby, D. M. (2007). Student performance problems in medical school clinical skills assessments. Acad Med, 82(10 Suppl), S69-S72. https://doi.org/10.1097/ACM.0b013e31814003e8
  9. Kneebone, R., Nestel, D., Wetzel, C., Black, S., Jacklin, R., Aggarwal, R., ... Darzi, A. (2006). The human face of simulation: Patient-focused simulation training. Acad Med, 81(10), 919-924. https://doi.org/10.1097/01.ACM.0000238323.73623.c2
  10. Kurtz, S., Silverman, J. & Draper, J. (2004). Teaching and learning communication skills in medicine (2nd ed.). Oxford: Radcliffe Medical.
  11. Ledingham, I. M. (1998). Twelve tips for setting up a clinical skills training facility. Med Teach, 20(6), 503-507. https://doi.org/10.1080/01421599880201
  12. Maguire, G. P., & Rutter, D. R. (1976). History-taking for medical students: I-Deficiencies in performance. Lancet, 2(7985), 556-558.
  13. Maguire, P., Fairbairn, S., & Fletcher, C. (1986). Consultation skills of young doctors: II--Most young doctors are bad at giving information. Br Med J (Clin Res Ed), 292(6535), 1576-1578. https://doi.org/10.1136/bmj.292.6535.1576
  14. Mandin, H., Jones, A., Woloschuk, W., & Harasym, P. (1997). Helping students learn to think like experts when solving clinical problems. Acad Med, 72(3), 173-179. https://doi.org/10.1097/00001888-199703000-00009
  15. Mavis, B. E., Wagner, D. P., Henry, R. C., Carravallah, L., Gold, J., Maurer, J., ... Prins, V. W. (2013). Documenting clinical performance problems among medical students: Feedback for learner remediation and curriculum enhancement. Med Educ Online, 18, 20598. https://doi.org/10.3402/meo.v18i0.20598
  16. Meyers, M. O., Meyer, A. A., Stewart, R. D., Dreesen, E. B., Barrick, J., Lange, P. A., & Farrell, T. M. (2011). Teaching technical skills to medical students during a surgery clerkship: Results of a small group curriculum. J Surg Res, 166(2), 171-175. https://doi.org/10.1016/j.jss.2010.05.019
  17. Park, H., Han, J., Kim, J., Shin, J. S., & Kim, Y. H. (2012). The analysis on the impact of clinical skills assessment in Korean Medical Licensing Examination and strategies for improvement. Seoul: Korean Medical Association.
  18. Paul, S., Dawson, K. P., Lanphear, J. H., & Cheema, M. Y. (1998). Video recording feedback: A feasible and effective approach to teaching history-taking and physical examination skills in undergraduate paediatric medicine. Med Educ, 32(3), 332-336. https://doi.org/10.1046/j.1365-2923.1998.00197.x
  19. Peitzman, S. J., & Cuddy, M. M.(2015). Performance in physical examination on the USMLE step 2 clinical skills examination. Acad Med, 90(2), 209-213. https://doi.org/10.1097/ACM.0000000000000570
  20. Platt, F. W., & McMath, J. C. (1979). Clinical hypocompetence: The interview. Ann Intern Med, 91(6), 898-902. https://doi.org/10.7326/0003-4819-91-6-898
  21. Roh, H. (2009). Development of the competencies for managing and preventing surgical errors with the patient safety education during surgical clerkship (Doctoral dissertation), Seoul National University, Seoul, Korea.
  22. Roh, H., Park, K. H., Jeon, Y., Park, S. G., & Lee, J. (2015a). Medical students' agenda-setting abilities during medical interviews. Korean J Med Educ, 27(2), 77-86. https://doi.org/10.3946/kjme.2015.27.2.77
  23. Roh, H., Lee, K., Eo, E, Hong, Y. S., Lee, H., Jang, B. W., & Rhee, B. D. (2015b). Development of guide to clinical performance and basic clinical skills for medical students. Korean J Med Educ, 27(4), 309-319. https://doi.org/10.3946/kjme.2015.27.4.309
  24. Roh, H. (2016a). Teaching and learning the physical examination and technical skills. In Korean Association of Medical Colleges (Ed.), The guide to basic clinical skills (2nd ed., pp. 475-487). Seoul: GabU Munhwasa.
  25. Roh, H. (2016b). Teaching and learning strategy for clinical performance. In Korean Association of Medical Colleges (Ed.), The guide to clinical performance (2nd ed., pp. 36-49). Seoul: GabU Munhwasa.
  26. Safi, S., Hemmati, P., Shirazi-Beheshtiha, S. H., Aslani, F., Taghdiri, M. R., Abadiyeh, R., & Tsai, T. C. (2012). Developing a clinical presentation curriculum in veterinary education: A cognitive perspective. Comp Clin Pathol, 21(6), 1521-1526. https://doi.org/10.1007/s00580-011-1323-3
  27. Seo, J., Kong, H., Im, S., Roh, H., Kim, D., Bae, H., & Oh, Y. (2016). A pilot study on the evaluation of medical student documentation: assessment of SOAP notes. Korean J Med Educ, 28(2), 237-241. https://doi.org/10.3946/kjme.2016.26
  28. Silverman, J., Kurtz, S., & Draper, J. (2013). Skills for communicating with patients (3rd ed). London: Radcliffe Publishing Ltd.
  29. The National Patient Safety Foundation. (2010). Unmet needs: Teaching physicians to provide safe patient care. Retrieved from http://c.ymcdn.com/ sites/www.npsf.org/resource/resmgr/LLI/LLI-Unmet-Needs-Report.pdf
  30. White, C. B., Kumagai A. K., & Barnes, G. D. (2006). Understanding and using active learning theory and methods. Preconference workshop at 2006 conference of Association for Medical Education in Europe.

Cited by

  1. Developing a clinical presentation dental education model and a pilot test vol.25, pp.1, 2016, https://doi.org/10.1111/eje.12578
  2. e-Learning for enhancement of medical student performance at the Objective Structured Clinical Examination (OSCE) vol.16, pp.7, 2016, https://doi.org/10.1371/journal.pone.0253860