title: Clinical training in medical students during preclinical years in the skill lab.
abstract: BACKGROUND
  In Nepal, medical education is a high-stakes and stressful course. To enhance learning and minimize students' stress, the conventional method has been replaced by integrated, student-centered learning. As an approach to train effectively, colleges have started establishing skill labs.
  
  
  OBJECTIVE
  To evaluate the effectiveness of clinical skill training on exam performance as compared with the conventional teaching practice. Further, to assess the perceptions of students of the importance of skill lab training in college.
  
  
  METHODS
  Twenty students were randomly selected to participate in this cross-sectional study. On the internal examination, students showed skills on manikins, and examiners evaluated them. A sample question in the exam was "To perform cardiopulmonary resuscitation (CPR) on half body human manikin." On completion of the exam, opinions were collected from the students via a predesigned self-administered questionnaire. The questionnaire included questions regarding skill lab use and its benefits to them in developing their skills, with a few questions related to the exam pattern. The responses were expressed in frequencies.
  
  
  RESULTS
  We found that all (20/20) students performed CPR with confidence and without hesitation on the manikin. The practical examination performance (marks) was categorized as excellent (7/20), good (8/20), average (3/20), and poor (2/20). The pass percentage after skill training was increased by 25% as compared with conventional teaching practice. The majority of the students (17/20) mentioned that skill is better learned by doing than by observing others' performance or watching videos. A few students (6/20) said skills are better learned by observing the real disease state. They mentioned that skill lab is the better choice for learning major skills such as catheterization, opening vein, auscultation of heart sounds, and endotracheal intubation.
  
  
  CONCLUSIONS
  Students are confident and showed better exam performance after basic clinical skills training in the lab. They perceived skill lab training as a better teaching method for the preclinical students.
authors.affiliation: Department of Physiology, Gandaki Medical College Teaching Hospital and Research Center, Kaski, Nepal.
authors.forename: Namrata
authors.initials: N
authors.lastname: Upadhayay
keywords: innovative learning; practical examination; preclinical years; skill lab