ePoster
Impact of a preparatory English language clinical skills program on the competence and self-efficacy of Japanese Medical Students wishing to study abroad

Authors

  1. Kazumi Sakashita (1)
  2. Rintaro Imafuku (1)
  3. Iyo Kubota (1)
  4. Takuya Saiki (1)
  5. Yasuyuki Suzuki (1)
  6. Farhan Bhanji (2)

Theme

International Dimensions

INSTITUTION

Gifu University Medical Education Development Center, Japan (1)
McGill University, Centre for Medical Education, Montreal, Canada (2)

Background
  • An international clerkship in English-speaking countries is often education al for medical students from non-English speaking countries. 

 

  • Prior studies suggest that these students face challenges to perform in clinical environments due to suboptimal spoken English language skills despite their adequate written English proficiency.

 

  • Cultural differences also interfere with their clinical performance.

 

  • The aim of this studny was to determine whether our educational intervention impacted on students'  competence and self-efficacy in the clinical scenarios.

    

Summary of Work

  

  •   Study Design?Case Study (Conducted in 2012-2013)

 

  

  • Educational Intervention: Preparatory “Medical English” Programmm 

 

                     ? 9 sessions throughout the academic year

                     ? Focusing on basic clinical skills (History Taking, Physical Examination, Case Presentation) in Western context

  

 

  • Data Gathering/Assessment

                      ? A Simulated Clinical Encounter was used to assess participants' competence.

                     ? Students evaluated their own competence and self-efficacy before and after the program.

                     ? The Retrospective pre-post rating was utilized as it may be a more sensitive and valid measure of the effects of educational intervention, compared to traditional pre-post self-assessment.

 

  • Simulated Clinical Encounter

 

                     ? Each student completed one 10-minute clinical scenario which did not include Physical Examination skills.

                     ? A 'Blinded' North American and Australian trained physician scored by 5-point Likert scale (1 poor → 5 Excellent)

                         ♦ Communication Skill

                         ♦ History Taking Ability

 

 

  • Retrospective Pre and Post format for students

                      ? Students were asked to rate these three topics on 6-point Likert Scale.

                         ♦ Self-confidence in English Communication

                         ♦ History Taking Ability

                         ♦ Case Presentation Ability

 

  • Analysis

                    ? Attendance rate of each student

                    ? Performance in a stimulated clinical encounter

                    ? Retrospective pre-post self-assessment (t-test)

Summary of Results
  •   Attendees' descriptive data

       Number:  10

       Gender:   Male:Female =4:6

       Age:  Mean 23.3 (Range 23-24)

       TOEFL ITP®:  Mean 560.9 (Range 560-570)   (Pass = 550 = iBT 80)

 

  • Table:  Attendance Rate and Performance

 

Student

Attendance rate (%)

Communication Skill

History Taking Ability

Total

1

89

4.5

4.5

9

2

89

4

4

8

3

78

5

4.5

9.5

4

78

5

4

9

5

78

4

4

8

6

78

3.5

3.5

7

7

67

4

4

8

8

67

4

3.5

7.5

9

78*

3

2.5

5.5

10

44

3.5

2.5

6

Mean

75

4.05

3.7

7.8

 

 

 

 

 

 

 

 

 

 

Students with an attendance >60% scored statistically higher on the simulated clinical encounter than those with a lower attendance rate.

*This student was noted to be a frequent late comer throughout the program.

 

 

  • Table: Retrospective Pre and Post Result (n=10)
   

My confidence to communicate in English is:

1 Very Low – 6 Very High

Mean

p (Paired t-Tests)

Pre

2.3

<0.05

Post

3.6

My History Taking Ability is: 

 

1 Very Low – 6 Very High

 

Mean

p (Paired t-Tests)

Pre

2

<0.05

Post

3.8

My Case Presentation Ability is:

1 Very Low – 6 Very High

Mean

p (Paired t-Tests)

Pre

2

<0.05

Post

3.4

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Retrospective pre-post self-assessment revealed all students' self-efficacy was improved in terms of their English communication, history taking and case presentation skills (p<0.05).

 

Conclusion

 

  • In students with similar baseline competence in written English communication skills, our program may better prepare students for the type of clinical experience they would encounter in International Clerkship experiences.

 

  • The results suggest our program also helped students improve their self-efficacy in their communication and basic clinical skills. 

 

  • To fully evaluate the clinical improvement of students, we need to increase the number of simulated clinical encounters and perhaps use a non-interventional group to control for any maturational effects (though this may be ethically challenging to justify considering the data we have already accumulated).

 

  • Further research is needed to determine how the program actually influences students’ preparedness and performance in an international clerkship.  

 

 

Take-home Messages

 

 

A preparatory Medical English course may improve clinical abilities, communication skills and self-efficacy in students planning to undertake international electives.

  

 

 

Acknowledgement

We thank for medical students in Gifu University School of medicine who participated in the program as well as this study.

 

References

 

1.B utler, Y. G., & Iino, M. (2005). Current Japanese reforms in English language education: the 2003 “a ction plan”. Language Policy, 4(1), 25-45.

2. B 22.olton, K. (2008). English in Asia, Asian Englishes, and the issue of proficiency. English Today, 94, 3.

 

 

3. van Zant en, M., Boulet, J. R., McKinley, D. W., DeChamplain, A., & Jobe, A. C. (2007). Assessing the communication and interpersonal skills of graduates of international medical schools as part of the United States Medical Licensing Exam (USMLE) Step 2 Clinical Skills (CS) Exam. Academic Medicine, 82(10), S65-S68. 

 

  

4. Skeff, K. M., Stratos, G. A., & Bergen, M. R. (1992). Evaluation of a Medical Faculty Development Program A Comparison of Traditional Pre/Post and Retrospective Pre/Post Self-Assessment Ratings. Evaluation & the Health Professions, 15(3), 350-366.

 

5. Bhanji, F., Gottesman, R., de Grave, W., Steinert, Y., & Winer, L. R. (2012). The Retrospective Pre–Post: A Practical Method to Evaluate Learning from an Educational Program. Academic  Emergency Medicine, 19(2), 189-194. 

 

6. McLeod, P. J., Steinert, Y., & Snell, L. (2008). Use of retrospective pre/post assessments in faculty development. Medical Education, 42(5), 543-543.

 

 

 

Background
Summary of Work

 

Session

Context

1

Orientation

2

History Taking/ Clinical Reasoning

3

History Taking/ Clinical Reasoning

4

Physical Examination Module I

5

Physical Examination Module II

6

Case Presentation

7

Case Presentation

8

Focused History Taking/Physical Exam/Case Presentation

9

Focused History Taking/Physical Exam/Case Presentation 

Summary of Results
Conclusion
Take-home Messages
Acknowledgement
References
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