title: Improving efficiency of clinical skills training: a randomized trial.
abstract: BACKGROUND
  The rising number of medical students and the impact this has on students' learning of clinical skills is a matter of concern. Cooperative learning in pairs, called dyad training, might help address this situation.
  
  
  OBJECTIVE
  The aim of this study was to evaluate the effect of dyad training on students' patient encounter skills.
  
  
  METHODS
  Experimental, randomized, observer-blinded trial.
  
  
  METHODS
  Forty-nine pre-clerkship medical students without prior clinical experience.
  
  
  METHODS
  All students underwent a 4-h course on how to manage patient encounters. Subsequently, the students were randomized into a dyad practice group (n = 24) or a single practice group (n = 25). Both groups practiced for 4 h on four different case scenarios, using simulated patients. Students in the dyad group practiced together and took turns as the active participant, whereas students in the single group practiced alone.
  
  
  METHODS
  Performance tests of patient encounter skills were conducted 2 weeks after the training by two blinded raters. Students had no clinical training during those weeks. A questionnaire-based evaluation surveyed students' confidence in their patient management skills.
  
  
  RESULTS
  The dyad group scored significantly higher on the performance test, mean 40.7 % (SD 6.6), than the single group, mean 36.9 % (SD 5.8), P = 0.04, effect size 0.61. Inter-rater reliability was 0.69. The dyad group expressed significantly higher confidence in managing future clinical patient encounters than the single group, mean 7.6 (SD 0.9) vs. mean 6.5 (SD 1.1), respectively, P < 0.001, effect size 1.16.
  
  
  CONCLUSIONS
  Dyad training of pre-clerkship medical students' patient encounter skills is effective, efficient, and prompts higher confidence in managing future patient encounters compared to training alone. This training format may help maintain high-quality medical training in the face of an increasing number of students in medical schools.
authors.affiliation: Centre for Clinical Education, University of Copenhagen, Department 5404, Blegdamsvej 9, 2100 Copenhagen, Denmark. martintolsgaard@gmail.com
authors.forename: Martin G
authors.initials: MG
authors.lastname: Tolsgaard
authors.forename: Sebastian
authors.initials: S
authors.lastname: Bjørck
authors.forename: Maria B
authors.initials: MB
authors.lastname: Rasmussen
authors.forename: Amandus
authors.initials: A
authors.lastname: Gustafsson
authors.forename: Charlotte
authors.initials: C
authors.lastname: Ringsted
mesh_terms: D000328:Adult; D002983:Clinical Competence / Q000592:standards*; D015331:Cohort Studies; D003479:Curriculum / Q000592:standards*; D004504:Education, Medical, Undergraduate / Q000379:methods / Q000592:standards*; D017598:Efficiency, Organizational / Q000592:standards*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D016037:Single-Blind Method; D013337:Students, Medical; D055815:Young Adult