Evaluation of the impact of an online introductory paediatric physical examination skills course on students' OSCE...

Videos demonstrating clinical skills are considered powerful educational tools. However, there is limited evidence on the effectiveness of comprehensive multimedia skills courses on knowledge and skills acquisition. We used cognitive load theory to develop an online course to introduce medical students to core paediatric physical examination concepts and skills, within a resource-constrained learning environment with high student-to-clinical teacher ratios. This study evaluated the impact and acceptance of the online course.

We used an observational quasi-experimental analysis for the impact evaluation. The main outcome was students' marks for the paediatrics station in the final paper-based observed structured clinical examination (OSCE). We measured the frequency of viewing core course content and used the median number of views to divide 351 fourth-year students into low and high users. Propensity score matching analysis was used to adjust for potential selection biases of course use. Low- and high-users were matched on gender, age, type of course entry, previous academic performance, and OSCE group before calculating the average treatment effect (ATE). The matched ATE was also calculated for different sub-groups of the class. A voluntary, online, cross-sectional survey about the course was administered post-OSCE. Closed-ended survey responses were analysed using descriptive statistics, and open-ended questions using content analysis.

Increased course usage significantly increased performance in the paediatrics component of the OSCE: high course users scored an average of 7.0% points [95%CI: 3.8-10.2] higher. The impact of the course was greatest for the middle 60% of the class, in terms of previous academic performance, with a matched ATE of 8.2% [95%CI: 4.3-12.2]. The survey response rate was 74.9%. The respondents expressed positive perceptions about the overall value of the course, including the clearly presented content that fostered an appreciation for paediatrics and prepared them for hospital rotations and the OSCE.

This study demonstrates that an online paediatric physical examination skills course can significantly improve students' examination performance, particularly for those in the middle academic performance range. The findings support the integration of multimedia clinical skills courses in medical curricula, especially in resource-constrained settings.