Effects of partial substitution of pre-clinical skills training by attachments to primary health care centers: An experimental study

Background: Recent studies indicate that students may encounter problems when they have to apply clinical skills learned in a skills laboratory to patients. To facilitate this transition, it has been advised to include patient contacts early in the pre-clinical curriculum. Objective: To compare clinical skills performance and level of preparedness for entering the clerkships between students who were prepared exclusively in a skills laboratory and peers for whom part of their skills training program was substituted by training in a primary health care (PHC) center. Methods: Pre-clinical students either trained clinical skills exclusively in a skills laboratory while their peers attended a mixed program of laboratory trainings and practice in PHC centers. Students' perception of preparedness for the clerkships was explored through the Preparation for Hospital Practice Questionnaire. Students' clinical skills were assessed by an Objective Structured Clinical Examination (OSCE) and by supervisors in PHC centers. Results: Students following the mixed program felt better prepared for their clerkships than skills lab-trained peers. Students' perceptions were supported by assessments by their supervisors. However, mean OSCE scores of both groups did not differ significantly. Conclusion: PHC centers can be involved to better prepare pre-clinical students for their clerkships.