Acquisition of history taking, physical examination and communication skills through early clinical exposure among pre-clinical students.

Introduction: Early Clinical Exposure (ECE) has been shown to be an effective method in teaching history-taking, physical examination and communication to pre-clinical students. Medical students in their preclinical years at IOM, MMC have been undergoing two year ECE course since 1978, but there is no provision of formative and summative assessment to check its effectiveness. This cross-sectional study was undertaken to fill this gap in evidence. Methods: A 17-station Objective Structured Clinical Examination was administered to 17 pre-clinical students. Of the 17 stations, seven, six and four stations were designed to test their skills in history-taking, clinical-examination and communication domains respectively. Modified borderline regression method was used to calculate the pass-marks for each station. The pass-marks of all the stations were averaged to determine the pass-marks for the entire OSCE. Results: One student passed the entire OSCE whereas four and eight students passed the history taking and communication skills domains; while none could pass the physical examination skills domain. Repeated measure one-way Analysis Of Variance (ANOVA) and post-hoc test using the Bonferroni correction showed that scores in history taking (M = 44.36, SD = 11.09) and communication skills (M = 44.40, SD = 12.12) were significantly better than in physical examination (M = 29.35, SD = 10.50), (p < 0.001 and p = 0.007, respectively). Conclusions: Despite enormous teaching hours allocated to the ECE course, pre-clinical students' performance in an OSCE did not meet the expectation of the curriculum suggesting that the ECE course at MMC, IOM is not fulfilling its objectives. [ABSTRACT FROM AUTHOR]