Clinical skills in final-year medical students: the relationship between self-reported confidence and direct observation by faculty or residents.
BACKGROUND
Many students, while performing clinical skills such as medical interviewing/ communication, physical examination, and procedural tasks, have never been observed by faculty members or residents. This study aimed to explore the relationships between final-year medical students' self-reported confidence and the frequency of direct observation by faculty member or resident while conducting these clinical skills.


METHODS
Medical students at China Medical University in Taiwan participated in the survey. Before graduating, they were asked to answer a questionnaire about (1) their confidence in performing 17 clinical skills including medical interviewing/communication, physical examination, and procedural tasks, and (2) the number of times they had been directly observed by faculty members or residents during student-patient encounters.


RESULTS
Many students reported never having been observed by a faculty member while they performed history taking/communication (46% to 84%), physical examination (36% to 42%), or procedural tasks (41% to 81%). It was found that residents had observed the students more frequently than the faculty members. The correlations between self-reported confidence and the corresponded direct observation were small to medium but significant. However, no difference was found between observation by a faculty member and by a resident.


CONCLUSIONS
This study confirmed that many medical students have not been directly observed in clinical training; and that those who were observed more often, expressed more self-reported confidence. Some assessment measures, which focus on direct observation and feedback during student-patient encounters, may improve the students' confidence.
Chen
Walter
W
School of Medicine, China Medical University, Taichung, Taiwan, ROC. chenwalt@yahoo.com
Liao
Shih-chieh
SC
Tsai
Chon-haw
CH
Huang
Chiu-ching
CC
Lin
Cheng-chieh
CC
Tsai
Chang-hai
CH
D000328:Adult; D002983:Clinical Competence / Q000592:standards*; D003625:Data Collection; D005260:Female; D006801:Humans; D007396:Internship and Residency; D008297:Male; D019370:Observation; D020377:Self Efficacy; D013337:Students, Medical; D013624:Taiwan