Medical students loose their competence in clinical skills if not applied on real patients: Results of two-year cohort study

Abstract

Objective: Investigating loss of competence (LoC) in clinical skills of medical students over time, predictive factors on competency loss, and determining efficiency of refresher training on skill retention. Material and Methods: The second and third-year students (n=170 and 160 respectively), who gained skills of blood pressure measurement, taking pulse and body temperature in the first year of their medical education, were invited to vocational skills laboratory to perform these skills. Their performance for each skill was scored over 100 using standardized assessment forms. Socio-demographic characteristics and variables possibly effective on LoC were determined by a questionnaire. Next academic year, 159 third-year (former second-year) students received refresher training and performed the skills on real patients under observation. They sat for an objective structured clinical examination (OSCE) at the end of the third year. OSCE scores were used to explore efficiency of refresher training combined with real alife applications. Results: LoC was sig-nificant in all skills. Multiple regression analysis revealed that "performing the skills in real life" was the unique predictor of LoC for all skills. "Gaining the skill before medical school" predicted LoC in blood pressure measurement and taking body temperature. "Time" and "gender" were predictors n and for loss of blood measurement skills. "Restudying the same year" predicted LoC in taking body tem- 5 2009 perature. Third-year students' OSCE scores were higher than their performance scores attained one ' study. year ago. Conclusion: In time, LoC occurs in clinical skills of medical students if not performed after training. This can be compensated by refresher training and real life applications. © 2011 by Türkiye Klinikleri.