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Title

Dermatological Clinical Teaching of Undergraduate Medical Students Using Selected Patients and Cases Scenarios in the Classrooms versus Hospital Clinics Based Teaching

Theme

Best Practices in Student Engagement and Support

Authors

Dr. Sami Fatehi Abdalla MD
PhD
Dr.Sami A Aldaham MD

Institutions

Faculty of Medicine,Almaarefa Colleges

College of Medicine,Al Imam Mohammad Ibn Saud Islamic University

Background

Why we taught our students dermatology on the campus?

No doubt the clinical teaching in its real sites is of tremendous importance for medical students learning. All clinical academicians agree that there is no equivalent replacement for the hospital-based clinical teaching for the medical students, as it will expose the students to the factual prospective circumstances they will soon work within (1). But on the other hand, many authors as Ibry who concluded, from his wide thematic analysis to many concerned manuscripts, that the clinical teaching with its current setting is variable, unpredictable, and immediate and lacks continuity (2). Dermatology is not an exception, but it is mainly practiced as an out-patient discipline, and the out-patient circumstance can be easily imitated inside the college classrooms. These two points in addition to the frequent complaints from our students about a lot of time they wasted within the clinics of dermatology waiting to see patients,  whom on many occasions refused to be seen by the medical students and many of these patients were actually not suitable for teaching

How we teach dermatology at Almaarefa, Faculty of Medicine?

During 2013 and 2014 academic years dermatology was used to be taught in form of lectures inside the college and clinical teaching in the ordinary hospital settings. Currently and since 2013 we taught dermatology subject for semester nine medical students in a block course consisting of 17 days that distributed into 13 days of actual contact hours, 2 days for students preparation and 2 days for examinations. Since 2015 academic year we conducted the dermatologic objectives through lectures, class presentations, clinical projection scenarios and real dermatologic patients. The course ILOs submitted to students at the first introductory session. The clinical scenarios included 7 sessions that discussing the common dermatology diseases by using the differential diagnosis approach while the real cases focused mainly on history taking and dermatologic examination.

Summary of Work

This a retrospective, cross-sectional analytical study conducted with a general aim to evaluate the campus and hospital clinical teaching outcomes using the students results in the final clinical part of the dermatology examination as a comparative indicator.

Summary of Results

The means of the final results examination were calculated for all students who took dermatology examinations from 2013 to 2016, stratified into campus group (2013-2014) and hospital group (2015-2016). The mean for each academic year (2013-61),2014-62).(2015-57),(2016-56) and then for each group has been calculated and the two groups mean compared to each other, the P value (0.036 ) showed a significant statistical difference between the two groups which is supported by the calculation of the coefficient of variation to cancel the effect of inequality of students number between the two groups. 

Comparison of Final Results  of Clinical Examination Between the  Hospital and Campus Groups

 

   Students Groups

 

Number of students

Minimum marks obtained

Maximum marks obtained

Mean of marks for group

Std. Deviation

The coefficient of variation

Hospital-based group

140

42.00

70.00

61.8929

6.09717

9.9%

Campus-based group

369

32.00

70.00

57.0352

6.88464

12.1%

P-value = 0.036 

Conclusion

Our results went in line with what Pine and his group (3) statements that showed the learning in a  clinical environment has much strength in professional practice, explained their conclusion by the fact that the learners in the hospital are motivated by active participation. Looking at the difference between our two groups results, it was not great remarkable as many hospital-based teaching supporters may expect. On the other hand, this unremarkable  difference would be  acceptable if it was seen from Spencer and Slotnic  views (4-5) who stated that before the teaching of the undergraduate students,  certain preparations within hospital clinics should be ready as the  isolated clinics for them, which is impossible in the most available settings of our hospitals. 

Take-home Messages

In spite of the importance of clinical teaching in the real hospital settings, the campus or college –based teaching using well-selected cases with suitable settings and adjustments can give more respectable results related to time-saving and focusing teaching of dermatology. 

Acknowledgement

Great thanks to our faculty administration represented in the dean Professor Mamoun Kremli and his vice for academic affairs Professor Mohammad Abduljabbar who removed all financial and logistic obstacles that we faced to conduct this new trend in teaching dermatology and gave us in the clinical department a tremendous and unlimited support. Also, I have to thank Mr. Hassan Omer without him this work wouldn't see the light. 

References

  1. Fugill, M. (2005) Teaching and learning in dental student clinical practice. EUR J Dental Education, 9,131-136
  2. Irby, D.M. (1995) Teaching and learning in ambulatory care settings: a thematic review of the literature. Acad Med,70 (10),898-931.
  3. Pine, Cynthia, M., Goldrick, M. & Pauline, M. (2000) Application of behavioral science teaching by UK dental undergraduate. Eur J Dental Education, 4,49-56
  4. Slotnick, H.B. (1996) How doctors learn: the role of clinical problems across the medical school-to-practice continuum. Med Educ, 71,28–34.
  5. Spencer, J. (2003) Learning and teaching in the clinical environment. Be Med J, 326, 591–4.
Background
Summary of Work
Summary of Results
Conclusion
Take-home Messages
Acknowledgement
References
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