Assessment of structured physical examination skills training using a retro-pre-questionnaire.
OBJECTIVE
The effectiveness of physical examination skills (PES) training is very rarely assessed using the "post-then-pre" approach. In this study, a retro-pre-questionnaire was used to study the effect of structured physical examination skills training (SPEST) imparted to second-year undergraduate medical students.


METHODS
KIST Medical College (KISTMC) affiliated to Tribhuvan University Nepal admitted its first batch of MBBS students in November 2008. The university curriculum recommends the involvement of Medicine and Surgery Departments in PES training, but the methods for teaching and assessment are not well defined. KISTMC has made training more structured and involved the Medicine, Surgery, Gynaecology and Obstetrics, Orthopaedics, ENT, Ophthalmology, Paediatrics, and Family Medicine Departments. SPEST includes the teaching/learning of basic PES for 210 minutes once a week for 28 weeks. Self-assessment is done by using a retro-pre-questionnaire at the end of the last session of training, and these data are analysed using SPSS.


RESULTS
Out of 100 students, 98 participated in the objective structured clinical examination (OSCE); 82 completed the retro-pre-questionnaire. Forty-six skills representing various systems were selected for inclusion in the retro-pre-questionnaire from among the many skills taught in different departments. The average perceived skills score (maximum score, 46×4=184) before training was 15.9 and increased to 116.5 after training. The increase was statistically significant upon the application of a paired t-test.


CONCLUSIONS
The students perceived that their level of skills improved after the training. The retro-pre- instrument seems to be useful for assessing the learners' self-reported changes in PES after training if a large number of skills need to be assessed. However, it should be noted that although a retro-pre-questionnaire may reveal valuable information, it is not a substitute for an objective measure or gold standard.
KIST Medical College, Lalitpur, Nepal.
Rano Mal
RM
Piryani
KIST Medical College, Lalitpur, Nepal.
P Ravi
PR
Shankar
KIST Medical College, Lalitpur, Nepal.
Suneel
S
Piryani
KIST Medical College, Lalitpur, Nepal.
Trilok Pati
TP
Thapa
KIST Medical College, Lalitpur, Nepal.
Balmansingh
B
Karki
KIST Medical College, Lalitpur, Nepal.
Mahesh Prasad
MP
Khakurel
Patan Academy of Health Sciences, Lalitpur, Nepal.
Shital
S
Bhandary
Assessment; Physical examination skills; Training