Day 2 : Oral Presentations (Theme: Curriculum - Teaching & Learning)

Event Title

Students perception: transition from UGME Years I & II to clinical clerkship years: ready or not?

Presenter Information

Tabassum Zehra, Aga Khan University

Location

Lecture Hall 3

Start Date

27-1-2013 9:10 AM

Abstract

Background: Pre clerkship years prepare students for clinical education. Literature review shows that transition periods were the prime causes of stress. Students often report several challenging aspects of this transition, including the difficulties they encounter in applying clinical knowledge, adjusting to different clinical settings, and understanding new roles and responsibilities. Literature shows studies on student struggling in areas when they begin their early clinical training. The five year Aga Khan University (AKU) Undergraduate Medical Curriculum is divided into two main components 1& 2 pre clerkship years and 3-5 clinical clerkship years. There is a general perception among the clinical faculty and the expressed feelings of the students show that they are ill prepared for the clerkship years, moreover, for their first clerkship. The purpose of this study is to explore: 1) whether the perceptions are correct or not, 2) the student expectations of the necessary skills and their anxieties in order to develop recommendations for clinical skills committee/curriculum committee to ease the transition.

Objectives 1. To identify attributes that students perceive as essential prior to starting clerkship rotations

2. To identify areas of concern

3. To identify additional skills training required to ease transition into clerkships

Methods: A questionnaire was developed through literature review and was piloted on a group of Year 4 students for validation. Anonymous Cross section Survey was done with the Year 2 Medical school students with their informed consent at the time of their entering Year 3. Similarly a post transition survey was done while the same group of students was leaving Year 3 to provide an insight of the student perceptions of the required attributes, skills and their anxieties while moving from pre clerkship to clinical clerkship years under two dimensions i) Essential skills required and 2) Additional skills training to ease transition.

Results: A sample of n=85 completed the survey form out of 92. The results were analyzed on SPSS version 19. Student\'s t-test was used to compare the means. Chi square test was applied for comparing other parameters. Reliability of the questionnaire was found to be significant (α= 0.07). It is interesting and perhaps surprising to see that there is not a strong relationship between confidence levels of the students at different attributes at the time of entering Year 3 with their expectation of essential required skills before they enter the clinical years. In fact, for most items, it appeared that the students reported 95 - 100% essential required skill before entering the clinical years and even while they were exiting, like restructuring of clinical knowledge for reasoning, professional identity, understanding of roles and responsibilities, understanding of expectations of the clinical faculty, methods of feedback and assessment, performing clinical skills, self-assessment, work load, team dynamics and logistics of clinical setting.

Conclusions: The students perceived a shift of emphasis from theoretical knowledge in the preclinical years to clinically oriented knowledge and reasoning in the hospital. The emphasis moved from understanding underlying mechanisms of disease to recognizing clinical signs and symptoms and making treatment decisions along with the understanding of their roles. It was found that the early patient contacts during the year had increased their self-confidence, motivated them to study, helped them develop clinical reasoning skills, and inculcated a sense of responsibility. However the need for further training in the areas identified were agreed in general. The authors conclude that there is a need to further explore their expectations through focus group discussion in order to recommend stringent strategies to ease their transition.

Key words: transition, pre clinical, clerkship, undergraduate medical education

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Jan 27th, 9:10 AM Jan 27th, 9:20 AM

Students perception: transition from UGME Years I & II to clinical clerkship years: ready or not?

Lecture Hall 3

Background: Pre clerkship years prepare students for clinical education. Literature review shows that transition periods were the prime causes of stress. Students often report several challenging aspects of this transition, including the difficulties they encounter in applying clinical knowledge, adjusting to different clinical settings, and understanding new roles and responsibilities. Literature shows studies on student struggling in areas when they begin their early clinical training. The five year Aga Khan University (AKU) Undergraduate Medical Curriculum is divided into two main components 1& 2 pre clerkship years and 3-5 clinical clerkship years. There is a general perception among the clinical faculty and the expressed feelings of the students show that they are ill prepared for the clerkship years, moreover, for their first clerkship. The purpose of this study is to explore: 1) whether the perceptions are correct or not, 2) the student expectations of the necessary skills and their anxieties in order to develop recommendations for clinical skills committee/curriculum committee to ease the transition.

Objectives 1. To identify attributes that students perceive as essential prior to starting clerkship rotations

2. To identify areas of concern

3. To identify additional skills training required to ease transition into clerkships

Methods: A questionnaire was developed through literature review and was piloted on a group of Year 4 students for validation. Anonymous Cross section Survey was done with the Year 2 Medical school students with their informed consent at the time of their entering Year 3. Similarly a post transition survey was done while the same group of students was leaving Year 3 to provide an insight of the student perceptions of the required attributes, skills and their anxieties while moving from pre clerkship to clinical clerkship years under two dimensions i) Essential skills required and 2) Additional skills training to ease transition.

Results: A sample of n=85 completed the survey form out of 92. The results were analyzed on SPSS version 19. Student\'s t-test was used to compare the means. Chi square test was applied for comparing other parameters. Reliability of the questionnaire was found to be significant (α= 0.07). It is interesting and perhaps surprising to see that there is not a strong relationship between confidence levels of the students at different attributes at the time of entering Year 3 with their expectation of essential required skills before they enter the clinical years. In fact, for most items, it appeared that the students reported 95 - 100% essential required skill before entering the clinical years and even while they were exiting, like restructuring of clinical knowledge for reasoning, professional identity, understanding of roles and responsibilities, understanding of expectations of the clinical faculty, methods of feedback and assessment, performing clinical skills, self-assessment, work load, team dynamics and logistics of clinical setting.

Conclusions: The students perceived a shift of emphasis from theoretical knowledge in the preclinical years to clinically oriented knowledge and reasoning in the hospital. The emphasis moved from understanding underlying mechanisms of disease to recognizing clinical signs and symptoms and making treatment decisions along with the understanding of their roles. It was found that the early patient contacts during the year had increased their self-confidence, motivated them to study, helped them develop clinical reasoning skills, and inculcated a sense of responsibility. However the need for further training in the areas identified were agreed in general. The authors conclude that there is a need to further explore their expectations through focus group discussion in order to recommend stringent strategies to ease their transition.

Key words: transition, pre clinical, clerkship, undergraduate medical education