A clinical education program; design, implementation and evaluation experience

The major aims of this research study are to design a clinical elective program at the Faculty of Medicine at Dokuz Eylul University, to evaluate the performance of the students participating in the program compliant with the Clinical Education and Evaluation Laboratory (KEDLAB) and to determine the effectiveness of the program and the application evaluation. A clinical elective program with the theme of asthma and chronic obstructive pulmonary disease (COPD) was designed for the term 4 medical students and implemented between 16-26 June 2015. Training activities of the program were carried out at the Department of Chest Diseases, and the performance evaluation of the students was carried out at the Clinical Education and Evaluation Laboratory. The research study is of the experimental (intervention) type. In order to ensure the homogeneity, student volunteers who were matched based on the scores obtained from the Respiratory Circulatory Block exam during the year were randomly assigned to the control and experimental groups. All of the students attended the training activites such as the presentations, bedside, laboratory and polyclinic practices included in the program. Pre- and post-tests consisting of 30 multiple-choice questions with topic weights and difficulty levels similar to each other were applied to the students before and after the program. Objective Structured Clinical Examination (OSCE) consisting of 3 evaluation stations including clinical history taking, chest X-ray interpretation and pulmonary function test (PFT) was administered at the beginning and the end of the program at the KEDLAB. In addition, constructive feedback was provided to the students in the experimental group by enabling them to watch their video recordings belonging to the their first OSCE performances. Although there was a slight increase in the knowledge scores of the students after the training compared to the pre-training, no statistically significant difference was detected. Whereas the OSCE scores of the control and the experimental groups were similar before the training program, a significant difference was detected between the scores of the control and the experimental group after the training program. In particular, OSCE scores of the experimental group were significantly increased compared to the pre-training period. It is postulated that receiving feedback by watching their own performances positively affected the post-training performance of the students in the experimental group. There was a significant increase of the average scores given by the simulated patients compared to the pre-training performances of both experimental and research groups. Overall, it was determined that the experimental and research groups were satisfied with the training program and OSCE administration. To sum, it is recommended to implement elective internship programs in which students can acquire in-depth knowledge and skills in their areas of interest, and to support their development by providing students with the opportunity to monitor their own performance and receive feedback throughout clinical years.