MANUSCRIPT: A randomized controlled pilot trial comparing the impact of access to clinical endocrinology video demonstrations with access to usual revision resources on medical student performance of clinical endocrinology skills
Background Demonstrating competence in clinical skills is key to course completion for medical students. Methods of providing clinical instruction that foster immediate learning and potentially serve as longer-term repositories for on-demand revision, such as online videos demonstrating competent performance of clinical skills, are increasingly being used. However, their impact on learning has been little studied. The aim of this study was to determine the value of adjunctive on-demand video-based training for clinical skills acquisition by medical students in endocrinology.
Methods Following an endocrinology clinical tutorial program, 2nd year medical students in the pre-assessment revision period were recruited and randomized to either a set of bespoke on-line clinical skills training videos TV, or to revision as usual RAU. The skills demonstrated on video were history taking in diabetes mellitus DMH, examination for diabetes lower limb complications LLE, and examination for signs of thyroid disease TE. Students were assessed on these clinical skills in an observed structured clinical examination two weeks after randomization. Assessors were blinded to student randomization status.
Results For both diabetes related clinical skills assessment tasks, students in the TV group performed significantly better than those in the RAU group. There were no between group differences in thyroid examination performance. For the LLE, 91.7% n?=?11/12 of students randomized to the video were rated globally as competent at the skill compared with 40% n?=?4/10 of students not randomized to the video p?=?0.024. For the DMH, 83.3% n?=?10/12 of students randomized to the video were rated globally as competent at the skill compared with 20% n?=?2/10 of students not randomized to the video p?=?0.007.
Conclusion Exposure to high quality videos demonstrating clinical skills can significantly improve medical student skill performance in an observed structured clinical examination of these skills, when used as an adjunct to clinical skills face-to-face tutorials and deliberate practice of skills in a blended learning format. Video demonstrations can provide an enduring, on-demand, portable resource for revision, which can even be used at the bedside by learners. Such resources are cost-effectively scalable for large numbers of learners.
Written by Brian S McGowan, PhD
Dr. McGowan has served in leadership positions in numerous medical educational organizations and commercial supporters and is a Fellow of the Alliance (FACEhp). He founded the Outcomes Standardization Project, launched and hosted the Alliance Podcast, and most recently launched and hosts the JCEHP Emerging Best Practices in CPD podcast. In 2012 he Co-Founded ArcheMedX, Inc, a healthcare informatics and e-learning company to apply his research in practice.
