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Structured clinical teaching strategy.

S S Allen1, C J Bland, I B Harris

  • 1Department of Family Practice and Community Health, University of Minnesota, Minneapolis 55455.

Medical Teacher
|January 1, 1991
PubMed
Summary
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A structured exercise for low back pain did not improve medical students' examination skills. Even with one structured clinical experience, students showed no significant difference in Objective Structured Clinical Exam (OSCE) performance.

Area of Science:

  • Medical Education
  • Clinical Skills Assessment
  • Musculoskeletal Medicine

Background:

  • Structured clinical education is crucial for developing essential medical skills.
  • Medical curricula often limit opportunities for hands-on skill acquisition.
  • Low back pain is a common ambulatory care problem requiring specific examination skills.

Purpose of the Study:

  • To evaluate the impact of structured exercise on medical students' low back pain examination skills.
  • To determine if a single structured clinical experience improves skills compared to varied or no structured learning.

Main Methods:

  • 188 medical students were divided into four groups based on instructional intervention (structured exercise/reading, random experience/no reading, reading only, no experience/reading).

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  • Skills were assessed using an Objective Structured Clinical Exam (OSCE) with stations for back pain history and physical examination.
  • Analysis of variance (ANOVA) was used to compare OSCE scores across intervention groups.

    • Main Results:

    • No significant difference in OSCE scores was found between students in different instructional intervention groups.
    • A single structured clinical experience did not enhance students' ability to perform low back pain history or physical exams compared to other groups.

    Conclusions:

    • Assuring at least one structured clinical experience for a specific problem did not improve students' ability to assess low back pain.
    • Acquiring essential clinical skills likely requires systematic instructional strategies and repeated learning opportunities.