IS IT NECESSARY MORE PRACTICAL TRAINING IN THE DEGREE OF MEDICINE?

M.A. Pino Vázquez1, H. González García1, E. Urbaneja Rodríguez1, R. Garrote Molpeceres1, B. Izquierdo López1, V. Fernández Provencio1, S. Rodríguez Bodero1, M.B. Coco Martín2, A. Mayo Iscar1, R. Cuadrado Asensio3, C. Medina Pérez4, F.J. Álvarez Guisasola1

1University of Valladolid (SPAIN)
2European University Miguel de Cervantes (SPAIN)
3IOBA,University of Valladolid (SPAIN)
4University of Leon (SPAIN)
Introduction:
The development of competency-based curricula has contributed to the development of methods aimed at assessing competencies. When this evaluation has no place in spontaneous conditions in the workplace, it is developed in simulated conditions talking about “demonstration of competencies “. The objective structured clinical examination (OSCE) is not an evaluation method as such, but an organizational framework that can incorporate a variety of methods of examination. Besides, it is not a new technique as it has been used for many years to assess the capabilities of students in macroscopic anatomy, however it has been revived as a method of overcoming the problems associated with traditional clinical examination.

Objectives:
To determine the influence of previous training in skills on the results of a competency evaluation in pediatrics, analyzing the results of groups of students from the internal students.

Material and Methods:
148 sixth grade students enrolled in the Faculty of Medicine of Valladolid in the course of Pediatrics after participated in a teaching innovation project (virtual classroom, rotating structured tutor, portfolio and seminars simulation) were included. Three students who were unable to complete the process of educational innovation were unable to perform the test OSCE were excluded. The total sample who completed the entire process were 145 students, 38 males (26.2%) and 107 women (73.8%). Forty students belonged to the Academy of Internal Students. The latter develop a specific program of assistance to clinics and emergency services units from the fourth year of the race, which was a sample of students with more training in generic clinical skills and attitudes. Six of the 40 boarders were not internal students and they had not covered the whole referral program.

Results:
For assessing knowledge the group with previous knowledge was significantly better (p = 0.026) and there were no significant differences in the results of the test at the end of the teaching process results. For groups of competencies the internal students group obtained significantly better results in History-taking (p = 0.0017), Communication (p = 0.0007) and Management clinical situations (p = 0.0061). In the group of internal students versus non- internal there were significantly better marks in Classical Pediatrics ( 7.76 + 6.68 + 0.77 vs. 1.16 , p < 0.001 ) and with the average mark of the Bachelor ( 7.87 + 0.529 against 7,17+ 0.742 , p < 0.001 ).

Conclusions:
Our results show that training in clinical skills improves performance and competency assessment and also confirms the formative nature of this type of evaluation. It highlights the value of skills assessment and diagnosis of training as well as its weaknesses and strengths.