Medical students' clinical skills do not match their teachers' expectations: survey at Zagreb University School of Medicine, Croatia

Abstract

Aim: To evaluate self-assessed level of clinical skills of graduating medical students at Zagreb University School of Medicine and compare them with clinical skill levels expected by their teachers and those defined by a criterion standard.

Method: The study included all medical students (n=252) graduating from the Zagreb University School of Medicine in the 2004-2005 academic year and faculty members (n=129) involved in teaching clinical skills. The participants completed anonymous questionnaire listing 99 clinical skills divided into nine groups. Students were asked to assess their clinical skills on a 0-5 scale, and faculty members were asked to assess the minimum necessary level of clinical skills expected from graduating medical students, using the same 0-5 scale. We compared the assessment scores of faculty members with students' self-assessment scores. Participants were grouped according to their descriptive characteristics for further comparison.

Results: The response rate was 91% for students and 70% for faculty members. Students' self-assessment scores in all nine groups of clinical skills ranged from 2.2-/+0.8 to 3.8-/+0.5 and were lower than those defined by the criterion standard (3.0-4.0) and those expected by teachers (from 3.1-/+1.0 to 4.4-/+0.5) (P<0.001 for all). Students who had additional clinical skills training had higher scores in all groups of skills, ranging from 2.6-/+0.9 to 4.0-/+0.5 (P<0.001 for all). Male students had higher scores than female students in emergency (P<0.001), neurology (P=0.017), ear, nose, and throat (P=0.002), urology (P=0.003), and surgery skills (P=0.002). Teachers' expectations did not vary according to their sex, academic position, or specialty.

Conclusion: Students' self-assessed level of clinical skills was lower than that expected by their teachers. Education during clinical rotations is not focused on acquiring clinical skills, and additional clinical skills' training has a positive influence on students' self-assessed level of clinical skills. There was no consensus among teachers on the required level of students' clinical skills.

Figure 1

Differences between teachers’ expectations and students’ self-assessment scores at the Zagreb School of Medicine. Grey bars – teachers’ expectations; open bars – students’ self-assessment scores. Clinical skills score is presented as mean of the group of skills with 95% confidence interval as error bars. BS – elementary skills, ER – emergency skills, NEU – neurology skills, ENT – ear, nose, and throat skills, CP – cardiopulmonal skills, GI – gastrointestinal skills, URO – urology skills, SURG – surgery skills, Gyn&Ob – gynecology and obstetrics skills. P<0.05 for all groups of clinical skills (independent samples t test).