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About the skill lab

Topics:

  1. Introduction

  2. Integration of the clinical training into the curriculum

  3. List of skills in the diferent phases

  4. Student assessment in the skills lab

Introduction

The mission of Suez Canal University, Faculty of medicine, is to graduate competent physicians who are able to offer primary health care in the Egyptian community as well as secondary and tertiary care in any community allover the world.

Since its establishment in 1978, the school has been putting heavy emphasis on ethical considerations and mastery of basic clinical skills which constitute an important component of clinical competence.

The basic clinical skills refer to those practical skills that are necessary in encounters with patients; these skills are ranging from history taking to examining different body systems and performing some procedures which should be mastered by any physician.

The curriculum of Suez Canal University, Faculty of Medicine, is characterized by exposing the students, from the very early beginning of their attachment to the school, to patients gradually through the different educational years. This is done in a suitable environment which avoids the doctor/patient contact being used for initial practice. This suitable environment is the clinical skills lab.

The training in the clinical skills lab is not meant to be a substitute of clinical training with real patients, but rather a preparatory step to it, so that the students become in a much better shape as they start their training with patients.

The clinical skills lab started its activities in 1981; it was the first skills lab which has been established in Egypt at that time. The objectives of lab are:

  • Standardized training and evaluation of basic clinical skills; using the same tools for all the students.

  • Promotion of the humanistic attitudes in students approach to the patients.

The students are not allowed to examine any patient except after successful performance of examinations on their peers and/or models.

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Integration of the clinical training into the curriculum

Training in the clinical skills lab is integrated into the curriculum of the Suez Canal School of Medicine so as to serve the two main educational strategies of the College, which are the community-based education and the problem-based learning. The link of the clinical skills with either strategy varies according to the educational phase.

In phase I (pre-pathogenesis), the educational problems are organized into blocks which address sequential phases of human development from pre-natal life to senescence. In their community-based activities in the primary health care centers, students examine patients of the same phase of life as in the problems in their blocks. They have to perform certain clinical skills for each age group such as examination of visual acuity for school children, measuring pulse and blood pressure of the aged subjects, etc. In the skills lab, they are trained to perform these skills, using the standard checklists, before practicing on real patients.

In phase II (pathogenesis), the educational problems are grouped around diseases of the body systems and those problems form the core around which most other activities are organized. During this phase, medical problems are utilized to motivate the students to learn mainly basic medical sciences in addition to clinical sciences. At this level, students are not requested to make diagnosis or to discuss management plans; instead, they are supposed to be able to explain underlying basic mechanisms of the symptoms and signs of various diseases. Thus, the skills on which students are trained, in the skills lab, are intimately related to the problems they take in their small-group classes. For example, they are trained on the clinical examination of the heart during the block of cardiovascular problems.

In phase III (clerkship), students learn clinical interventional skills e.g. wound suturing, urinary catheterization, in order to be more confident and less liable to commit accidental mistakes as they practice such skills on the patients in the clerkship.

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List of skills in the different phases

Phase I skill lessons:-

  • Measuring blood pressure

  • Intramuscular and subcutaneous injection

  • Intravenous injection

  • Hearing test

  • Assessment of visual acuity

  • General examination

  • Cardiopulmonary resuscitation

Phase II skill lessons:-

  • General examination

  • Examination of mass and examination of breast

  • Lymph node examination

  • Pulse & jugular venous pressure examination

  • Chest examination

  • Heart examination and ECG procedure

  • Abdominal examination

  • Locomotor examination

  • Neurological system examination

  • Ear examination

  • Fundus examination

  • Thyroid examination

  • Rectal examination

  • Vaginal examination and IUD introduction

  • Male and female genitalia examination

Phase III skill lessons:-

  • Wound suturing

  • Episiotomy suturing

  • Male catheterization

  • Female catheterization

  • Nasal pack

  • Attendance of normal labor

  • Laryngoscopic examination

  • Revising any of the skills which have been taught in phases I and II according to the students’ needs.

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Student assessment in the skills lab

Evaluation in the skills lab aims at testing:-

  • The clinical performance of the students in different skills.

  • The background knowledge, of the students, in relation to different skills.

The evaluation is done periodically after each block. Each student receives feedback after every examination and he/she should prove mastery of all the skills, otherwise he/she would repeat the examination until reaching the mastery level (regarding performance). A final evaluation is done at the end of phase I & phase II.

The evaluation of performance is done by two observers who use the same standard checklists. The rating is independent and the observers are not aware of the weight of each step. There are four alternatives for marking each step: satisfactory, not satisfactory, not done or not applicable.

After each examination, the supervisors of the lab grade the checklists according to specific predetermined weight for each item and provide the students with feedback.

The scoring of the theoretical background test is done by the subject area experts according to an approved key answer sheet.

The students who fail in one or more of the skills can attend the lab at any time outside the schedule to repeat training with the help of an instructor or some available audiovisual aids.

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