The impact of formal instruction in clinical examination skills on medical student performance -- the example of peripheral nervous system examination.
BACKGROUND
Peripheral nervous system examination is an essential part of the full medical clerking of a patient. We have investigated the effectiveness of formal instruction in peripheral nervous system examination compared to the traditional bedside ward teaching that our students usually receive.


METHODS
We instructed an unselected group of 22 medical students in peripheral nervous system examination in a clinical skills centre and evaluated them with a 12 item marking schedule before and after instruction. The performance of this group was then compared to the rest of their year (220 students) in an end of year OSCE, which included a neurology station assessing sensory examination of the lower limbs.


RESULTS
Students formally instructed in neurology significantly improved their scores after instruction and scored 15% higher marks (90% vs. 75%) than the rest of their year in the end of year neurology OSCE station 2 months later (P < 0.01, Mann Whitney U-test). They did not perform significantly better in the OSCE overall.


CONCLUSIONS
Formal instruction in neurological examination resulted in a significant increase in the end of year neurology OSCE station score compared to traditional heterogeneous teaching methods.
Fox
R
R
Centre for Health Infomatics and Multiprofessional Education, Royal Free and University College Medical School, 4th Floor, Holburn Union Building, Whittington Hospital Campus, Highgate Hill, London N19 3UA, UK.
Dacre
J
J
McLure
C
C
D002983:Clinical Competence / Q000592:standards; D004504:Education, Medical, Undergraduate / Q000379:methods*; D004521:Educational Measurement; D006801:Humans; D008131:London; D009462:Neurology / Q000193:education*; D017933:Peripheral Nervous System; D013663:Teaching / Q000379:methods*