Addressing the Decline in Clinical Skills: A Call for Comprehensive Educational Reform

Authors

  • Muhammad Noor Wazir Hayatabad Medical Complex, Peshawar

DOI:

https://doi.org/10.37762/jgmds.11-3.609

Abstract

Despite technological advances, clinical skills are the foundation of medical practice. Taking a comprehensive clinical history, performing physical examinations, and communicating effectively are crucial for high-quality patient care. Medical students need to focus on developing strong clinical skills to ensure they are well-prepared for their careers and adapt to the evolving field of medicine through continual practice and refinement.1 The medical community is worried about declining essential clinical skills among undergraduate medical students.2,3 This editorial aims to analyze the reasons for the decline and suggest evidence-based methods to address the situation. 05885.0258063. The declining standards of clinical skills among medical students can be attributed to the widespread adoption of technology-based learning, which has the potential to diminish the importance of traditional hands-on bedside teaching.4 Technology should enhance, not replace, practical clinical experiences. Practical training improves the clinical abilities, expertise, and self-assurance of medical students.5 Moreover, the growing magnitude and expansion of medical curricula provide difficulties in the development of educational programs without ample time for bedside practical teaching.6,7 There is frequently an excessive focus on remembering facts rather than on cultivating clinical reasoning abilities.8 The reduced patient interaction during medical school, due to increased reliance on simulations and less time in clinical rotations and bedside teaching, hampers the development of clinical skills.9 External factors such as limited time and extensive paperwork may affect the quality of patient encounters. Efficient communication is crucial for building good relationships with patients, obtaining accurate medical histories, and ensuring patient understanding and adherence to treatment.9 Insufficient training in communication skills can result in less-than-ideal interactions between patients and healthcare providers and can also contribute to errors in diagnosis and medical treatment.10

 

The provision of trained faculty for teaching medical students is an issue worldwide. Insufficient supervision and feedback during clinical rotations hinder the development of essential clinical skills.11 Larger student cohorts reduce the opportunities for individual students to practice and receive personalized instruction in clinical skills.12 Medical education often prioritizes theoretical testing over practical examinations and undervalues communication skills training. Variability in clinical experiences at different medical schools can lead to inconsistencies in skill acquisition. The scarcity of skilled clinicians as role models impacts students’ learning. Economic constraints and modern healthcare pressures limit opportunities for thorough patient interactions and clinical training.13

 

THE WAY FORWARD

 

Educational institutions should prioritize hands-on clinical experiences throughout the curriculum to improve students’ diagnostic and communication abilities. These experiences should include simulation-based learning, standardized patients, and longitudinal clerkships. Faculty members need support and resources for effective clinical mentorship and development. Reflective practice should be integrated into the curriculum to enhance self-awareness and critical thinking. Open communication and mentorship programs between students and faculty can strengthen medical training and promote continual learning.

 

To address declining clinical proficiency among medical students, institutions can adopt evidence-based approaches including curriculum changes, faculty training, promoting reflective thinking, collaboration among healthcare professionals, and fostering a culture of ongoing learning. Regulatory bodies should ensure adequate time for bedside teaching and appropriate assessment weightage.

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Author Biography

Muhammad Noor Wazir, Hayatabad Medical Complex, Peshawar

Professor,
Department of Medicine,
Hayatabad Medical Complex

References

Holmboe ES. Faculty and the Observation of Trainees’ Clinical Skills: Problems and Opportunities. Acad Med 2004;79(1) https://journals.lww.com/academicmedicine/fulltext/2004/01000/faculty_and_the_observation_of_trainees__clinical.6.aspx DOI: https://doi.org/10.1097/00001888-200401000-00006

Goldstein EA, MacLaren CF, Smith S, Mengert TJ, Maestas RR, Foy HM, et al. Promoting Fundamental Clinical Skills: A Competency-Based College Approach at the University of Washington. Acad Med 2005;80(5) https://journals.lww.com/academicmedicine/fulltext/2005/05000/promoting_fundamental_clinical_skills__a.3.aspx DOI: https://doi.org/10.1097/00001888-200505000-00003

Sanson-Fisher RW, Rolfe IE, Williams N. Competency based teaching: the need for a new approach to teaching clinical skills in the undergraduate medical education course. Med Teach 2005;27(1):29-36 DOI: https://doi.org/10.1080/01421590400019500

Jingyan Lu. Will Medical Technology Deskill Doctors? Int Educ Stud 2016;9(7):130 DOI: https://doi.org/10.5539/ies.v9n7p130

Verghese A, Brady E, Kapur CC, Horwitz RI. The bedside evaluation: ritual and reason. Ann Intern Med 2011;155(8):550-553 DOI: https://doi.org/10.7326/0003-4819-155-8-201110180-00013

Alpert JS. Some Thoughts on Bedside Teaching. Am J Med 2009;122(3):203-204. DOI: https://doi.org/10.1016/j.amjmed.2008.10.024

Sultan AS. Bedside teaching: An indispensible tool for enhancing the clinical skills of undergraduate medical students. J Pak Med Assoc 2019;69(2):235-240.

Nyquist JG. Educating Physicians: A Call for Reform of Medical School and Residency. J Chiropr Educ 2011;25(2):193-195. DOI: https://doi.org/10.7899/1042-5055-25.2.193

Hauer KE, Holmboe ES, Kogan JR. Twelve tips for implementing tools for direct observation of medical trainees’ clinical skills during patient encounters. Med Teach 2011;33(1):27-33 DOI: https://doi.org/10.3109/0142159X.2010.507710

Ponte CD. Improving communication in the health care setting. Am J Heal Pharm 2011;68(8):666-667 DOI: https://doi.org/10.2146/ajhp100359

Ende J. Feedback in clinical medical education. JAMA 1983;250(6):777-781 DOI: https://doi.org/10.1001/jama.250.6.777

Crosby Joy RMH. AMEE Guide No 20: The good teacher is more than a lecturer - the twelve roles of the teacher. Med Teach 2000;22(4):334-347 DOI: https://doi.org/10.1080/014215900409429

Epstein RM. Assessment in medical education. N Engl J Med 2007;356(4):387-396 DOI: https://doi.org/10.1056/NEJMra054784

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Published

2024-06-30

How to Cite

Wazir, M. N. . (2024). Addressing the Decline in Clinical Skills: A Call for Comprehensive Educational Reform. Journal of Gandhara Medical and Dental Science, 11(3), 1–2. https://doi.org/10.37762/jgmds.11-3.609