Reflection and self-directed and group learning improve OSCE scores

Reflection and self-directed learning have been emphasised as important in the process of learning, and are inevitably applied in medical education. The effectiveness of reflection on learning outcomes and its application in medical education must be investigated.

In 2009, 86 fourth-year medical students at Kagoshima University took a course in basic clinical skills that included introductory lectures and small group training sessions. As part of these new educational interventions, the students received a lecture on reflective learning, wrote down their own reflections on skills training during the course, and voluntary participation in self- and group practice was promoted. Two weeks after the course, the students took six stations of the Objective Structured Clinical Examination (OSCE) via the Common Achievement Test. Each station and total score of the OSCE were compared with those from 2006-2008, and with national mean scores of the same station scenario in 2008.

Students wrote 966 reflection reports (11.2 reports per student), and actively used rooms and materials for self- and group practice. All station and total scores of the OSCE in 2009 were higher than those in 2008: the total scores of the OSCE, the physical examination (PE) station and suturing skills were significantly improved, but the scores for 'Interview' and 'Head and Neck' PE were not.

Our new educational intervention enabled students to experience some reflection on skills training, and facilitated students' experiential learning. We conclude that it was effective at least in the initial phase of basic clinical skills training. The students' reflection on communication skills needs to be improved.