First-year medical students at UAB will begin their education with a new, low-tech study aid by their sides – the newly designated clinical skills scholars, a select group of 31 faculty chosen in a competitive process for their ability to teach students the intangibles of becoming physicians.Taking a patient’s medical history, performing a physical exam and assessing patients is more complicated today than in years past because both physicians and patients have more demands on their time, said Craig Hoesley, M.D., associate dean for undergraduate medical education and a professor of Medicine. It’s also more difficult to teach students these skills because of increased demand on a faculty member’s time.
“We want people to know that we’re really committed to developing clinical skills in our students. It’s an important part of developing into a physician,” Hoesley said. The scholars’ home departments receive financial support from the School of Medicine to dedicate half a day each week to mentoring five to seven students for at least two years. The program is part of a new emphasis on clinical skills throughout the four-year curriculum, Hoesley said.
|See the list of 31 faculty named the 2013 Clinical Skills Scholars here.|
“Clinical skills are the fundamental skills doctors use to practice medicine, and at their core they involve interacting with patients and exhibiting professional behavior. They require much more than just possessing scientific knowledge -- they are skills you can’t merely read about in a book,” Massie said. “You have to learn and cultivate them with repeated practice under the guidance and mentoring of a practicing clinician.”
“In medical school, there is so much knowledge that students are expected to learn that sometimes clinical skills don’t get the attention and reinforcement that they deserve,” Massie said. He points to research showing many patients complain that doctors don’t listen and lack communication skills. “What students often see in the real world are not always the best practices.”
Implications of poor clinical skills include missed diagnoses and ordering inappropriate tests, which decreases quality and increases costs. It also leads patients to doctor-hop, which reduces continuity of care.
But, Massie says, research shows that medical students' communication skills deteriorate without formal training, however, other research shows that these same skills can be improved and enhanced by dedicated focus and formal training during medical school.
Clinical skills, Harada said, are “what make doctors doctors. This is the meat and potatoes of what we do, and we need to teach doctors how to talk with patients, how to examine patients and how to make diagnoses using good critical listening.
“Unless you have the skills to apply your medical knowledge, you’re not going to be able to do anything with that knowledge. That’s what the clinical skills course teaches,” said Harada, an assistant professor in Gerontology, Geriatrics and Palliative Care.
Another component of the clinical skills scholars program will be to study its methods and determine what works best and how to extend them over all four years of medical school, said White, an associate professor of Pediatric Emergency Medicine who also directs the medical student simulation program. “We want to make a great program even better,” she said. The scholars themselves will also receive training to sharpen their skills as teachers.
For students, the two-year longitudinal relationship with a mentor is key, Massie said, because it creates more ownership for both teacher and learner in the process and outcome of the student's training. “Students will be more compelled to learn the skills and do a good job. Mentors are more likely to take a vested interest to ensure that their students succeed.”