Can students learn clinical method in general practice? A randomised crossover trial based on objective structured...

Area of Science:

• Medical Education
• Clinical Skills Development
• Healthcare Professions Training

Background:

• Undergraduate medical education increasingly integrates diverse clinical environments.
• The relative effectiveness of general practice versus hospital settings for clinical skills acquisition requires investigation.
• Optimizing clinical placements is crucial for developing competent healthcare professionals.

Purpose of the Study:

• To compare the acquisition of clinical skills by medical students in general practice versus hospital settings.
• To identify differences in the learning of specific clinical skills between these two environments.
• To inform curriculum planning for undergraduate medical training.

Main Methods:

• A randomized crossover trial involving first-year clinical medical students.
• A 10-week internal medicine block, with half the time in general practice and half in hospital.
• Objective structured clinical examinations (OSCEs) at mid-point and end-point, with analysis of covariance for improvement.

Main Results:

• No significant difference in clinical skills acquisition between general practice and hospital settings in the first five weeks.
• Students in general practice demonstrated slightly greater improvement in clinical skills compared to hospital settings in the second five weeks (P = 0.007).
• High participation rates in examinations (92% completed both).

Conclusions:

• Clinical skills can be acquired effectively in both general practice and hospital settings.
• Further research is needed to determine optimal learning environments for specific skills, knowledge, and attitudes.
• Findings support the integration of general practice placements in undergraduate medical curricula.