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  • Author
    Monica Sheridan
  • Co-author

    Robert K. Oye, MD

  • Title

    Medical Students’ Perspective on the Clinical Skills II Curriculum

  • Abstract

    Context: The longitudinal clinical skills (CS) curriculum at David Geffen School of Medicine (DGSOM) teaches first and second-year medical students how to perform a physical exam and develop a differential diagnosis using the relevant findings. Due to the Covid-19 pandemic, students in the Class of 2023 were given the option of completing the course in-person or virtually.

    Objective: The present study aims to measure medical students’ confidence levels in performing physical exam maneuvers and ability to develop a differential diagnosis before and after completion of the second-year clinical skills curriculum. Secondly, the study aims to decipher any differences in student confidence levels for students who completed the course in-person vs virtually.

    Design: Participants took a one-time, online, anonymous, and voluntary survey. Students rated their confidence on a 5-point scale in the following areas: performing an overall physical exam, performing subsections of the physical exam (HEENT, cardiovascular, pulmonary, abdominal), and ability to generate a differential diagnosis. Students were given an opportunity to share additional feedback anonymously.

    Participants: 68 second-year medical students at DGSOM completed the survey from Nov 2020 to Feb 2021.

    Results: Of the 68 total participants 75% were female identifying. Participants were present from each instruction day (36% Tue, 32% Wed, 32% Thurs). 87% of students were near campus during CS instruction, despite nearly a third of students electing to take CS virtually. A significant portion of students (43%) reported being able to practice learned techniques less than once per month. Median exam confidence increased from “2- average” to “3” in the Tue cohort after the completion of the CS curriculum. There was no change in median exam confidence in the Wed or Thur cohort (“2” at start and end of CS). Median confidence in differential diagnosis synthesis increased from “1” to “3” in both Tue and Wed cohorts, and from “2- average” to “3” in the Thurs cohort. The highest endorsed barrier to learning CS was reported to be the lack of opportunity to practice on real patients.

    Conclusions: No significant differences were noted in student confidence in the in-person vs virtual subgroup. Due to social distancing requirements, curricular time of in-person groups had to be decreased from previous years. Decrease in instruction time and differential diagnosis case practice may have impacted student confidence. Exam performance confidence varied by exam subtype. The results suggest an unmet demand for more dedicated practice time during the pre-clinical years of medical education.

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