BASICS Endokrinologie (German Edition)

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Please click the link in that email to activate your subscription. Limited practical experience, however, leads to reduced self-confidence, hesitancy, and anxiety in students due to fear of causing harm to patients [ 10 ], [ 11 ]. In addition, there are currently no standardized tools to assess procedural skills competence of medical students prior to certification, leading to inequity of assessment and competence before qualification [ 12 ]. Two concepts aiming at preparing medical students better for the demands of their future profession are problem-based learning and the introduction of basic clinical skills courses [ 13 ].

At the Medical University of Graz, the human medicine curriculum covers six years and is divided into three stages [ http: During the first phase of study — lasting for one year — mainly natural sciences are taught, supplemented with an internship at a hospital ward. During the subsequent four years a modular system provides students with the required medical knowledge using clerkships to teach and train clinical skills.

Within these four years students have to go through 16 weeks hours of mandatory electives.

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Clerkships are predetermined clinical placements as part of the main curriculum, whereas electives are mandatory clinical activities of students in medical specialties of their own choice see Attachment 1. In order to complete the second stage of study students have to pass an OSCE, testing the performance of clinical skills and practical procedures. The course of study is finalized by another two semesters spent working at three hospital wards of different specialization and at a family physician.

In this article we want to report on the conceptual design and implementation of a novel course teaching basic clinical and procedural skills to first-year students. Furthermore, we are going to present the results of initial course evaluations. In spring , the Curriculum Commission decided to introduce a practical course aiming at preparing preclinical students better for compulsory clerkships and electives.

A work group was established, consisting of teachers of different medical specialties and of two experienced medical students working as student instructors at our Clinical Skills Center CSC. It was designated as a compulsory course for first-year students. For successful completion, students have to attend at least 85 per cent of the lessons and demonstrate sufficient theoretical preparation as well as active cooperation.

In November , first CEL courses were held. Beginning with necessary anatomical and physiological knowledge, this handbook describes the performance of clinical skills and procedures by using written text, procedural algorithms, and high-quality image series specifically developed for the course.

The CEL is a six-part course with two virtual and four practical phases. Ten hours have been designated as practical training time, four hours for the first and two hours for each of the following course parts. Teaching groups consist of three to six students at most, with every group being tutored by one of our CSC peer-teachers. Course participants learn how to take medical histories in a structured manner through patient-doctor role plays. Physical examination techniques are trained on a cardiopulmonary patient simulator and on fellow course participants.

Practice of relevant procedures, such as blood taking and injections, concludes the course. Students learn diagnostic modalities blood pressure measurement, electrocardiography recording , get to know important cardiac arrhythmias, train cardiopulmonary resuscitation and manual defibrillation, and recapitulate the main points of cardiovascular examination by working through four common heart valve diseases on our cardiopulmonary patient simulator.

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In our simulation operating theatre, students learn how to prepare for aseptic interventions, are shown the performance of wound toilet, disinfection, and local anesthesia, and train different forms of wound closure. Rounding out the course, catheterization of the urinary bladder is practiced on urologic manikins. First, airway management techniques are trained. Short emergency simulations using high-fidelity patient simulators finalize the course.

The medical emergencies trained are the ones previously used in the virtual course part. The goal of the simulation sequences is the integrated practice of skills acquired throughout the CEL in a realistic setting.

Its multiple-choice questions focus on the contents of the practical courses. The CEL is based on several didactic elements: The course parts build on each other and contain repetitive sequences for maximization of learning outcomes. In addition to the compulsory courses, students are invited to train at our CSC in their course-free time. Four course evaluations have been carried out so far February, May, and July ; February Every student who had passed at least one practical course part at the time of the respective evaluation was defined eligible for our study and asked to complete an online questionnaire on a voluntary basis.

The standard course questionnaires of the Medical University of Graz were used. We combined the results of these evaluations. A total number of students voluntarily participated in the course evaluation and, therefore, completed questionnaires were included in our analysis. Students strongly agreed that the contents of the CEL were important for their future profession 1.

Statements referring to perceived theoretical and practical learning outcomes both received high approval 1. Most students participated with pleasure 1. Two thirds of the students Further details of course evaluations are summarized in Figure 1 Fig. Almost all comments about positive aspects of the CEL could be attributed to one of four categories. Analysis of free-text comments revealed four major topics for course improvement. Twenty-seven comments asked for organizational adaptions, especially regarding the enrolment process.

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First evaluations have displayed high student satisfaction with the CEL concept. Students especially valued the opportunity to actively practice various clinical skills, the quality of our peer-teachers, clinical relevance of course contents, and the use of simulation-based education. The course evaluations revealed possibilities for improvement as well. The most frequent suggestion was the extension of course duration. Although difficult to implement given the tight timetable of first-year students, this idea will receive ample consideration.

Improving the organizational handling of the CEL was another focal point.

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Initially, students chose course dates individually via our online course system. It has to be evaluated how well the skills acquired at our CSC will translate into the clinical stage of study. It must not be forgotten that training in the skills laboratory does not replace, but supplement clinical experience [ 10 ]. However, in the study by Nielsen et al. Students within an innovative curriculum with skills laboratory training from the first year of study are better trained in basic clinical skills and, therefore, better prepared for clerkships, compared to students in traditional curricula [ 17 ].

Thus, we are optimistic that the CEL provides students with the necessary competence and confidence to successfully perform medical skills and practical procedures in the clinical setting. Based on first course evaluations, factors contributing most to this success are hands-on training, motivated and experienced student instructors, clinically relevant contents, and the utilization of medical simulation. The most common suggestion for improvement was an extension of course duration.