title: Medical students' comfort levels with performing the basic head and neck examination in practice: follow-up during the core clerkship year.
abstract: OBJECTIVE
  Following our preliminary study on junior medical students' comfort levels in performing the head and neck physical examination (H&NPE) before and after a department-led teaching session, we assessed the longitudinal effect of this session on students during the core clinical clerkship year, in which these skills were performed on real patients.
  
  
  METHODS
  Anonymous cross-sectional survey study as a follow-up to previous intervention.
  
  
  METHODS
  Overall, 101 and 90 second-year medical students participated in an H&NPE teaching session 1 year before the current survey administration in 2 consecutive years. The same cohorts of students, as third years, were asked to rate their comfort levels (0-5-point Likert scale) in performing the H&NPE and the importance of otolaryngology rotations in medical school and primary care residency training.
  
  
  RESULTS
  Of the 101 and 90 students, 53 and 46 medical students completed the follow-up survey in each respective year. For both classes, compared with before the teaching session, students reported an average comfort level of 2.8 (somewhat to moderately comfortable) in performing the complete H&NPE (p < 0.0001) during the core clinical clerkship year. Similar changes were observed for the individual ear, nose, mouth, and neck components of the examination (all p's < 0.0002). Students at follow-up reported statistically similar comfort levels when compared with immediately after the teaching session for the ear, oral cavity, and neck examinations.
  
  
  CONCLUSIONS
  The initial teaching session persistently improved medical students' comfort levels in performing the H&NPE, with some attrition in comfort levels with performing the nasal examination and complete H&NPE. An otolaryngologist-directed, practical educational intervention may permanently reinforce the acquisition of complex skills such as the H&NPE.
authors.affiliation: Department of Head and Neck Surgery, University of California, Los Angeles, California.
authors.forename: Edward C
authors.initials: EC
authors.lastname: Kuan
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, California.
authors.forename: Karam W
authors.initials: KW
authors.lastname: Badran
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, California.
authors.forename: Victor
authors.initials: V
authors.lastname: Passy
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, California. Electronic address: wbarmstr@uci.edu.
authors.forename: William B
authors.initials: WB
authors.lastname: Armstrong
mesh_terms: D001291:Attitude of Health Personnel; D002982:Clinical Clerkship; D002983:Clinical Competence; D004504:Education, Medical, Undergraduate; D006257:Head; D006801:Humans; D009333:Neck; D010036:Otolaryngology / Q000193:education*; D010808:Physical Examination; D013337:Students, Medical
keywords: Interpersonal and Communication Skills; Medical Knowledge; Patient Care; Practice-Based Learning and Improvement; general otolaryngology; head and neck examination; medical education