Clinical skills lab in Korea

Abstract

Clinical skills laboratory has become one of the essential modalities in an undergraduate medical education. A variety of clinical skills can be trained through this program including physical examination, diagnostic and therapeutic skills as well as communication skills. It may consist of simulators, models, standardized patients and/or sophisticated simulation models with programmed clinical situations. In Korea, a couple of medical schools launched clinical skills lab for undergraduate medical education (UME). They also extended the program into other educational area of practical skills training. Many other medical schools are also ready to start the program in the near future. Major drives for the trends in the promotion of clinical skills lab in Korean medical schools are as follows. 1) The plan to introduce clinical skills test in the Korean medical license exam, 2) needs of safe and effective environment for clinical skills training before and during a clinical clerkship, 3) advantage of earlier exposure to the authentic clinical situations even in the course of basic science, 4) complementary actions for the relative lack of skill training opportunity in the UME. There are a few barriers for the activation of clinical skills lab. Monetary burden for space, personnel, coordination system, and intermingled educational infrastructure are only a few of those concerns. However medical students are anxious to practice their skills in a safe but well-organized systems from the beginning of their course to clinical medicine. In Hanyang university medical college, clinical skills training workshop made third year medical students to have greater confidence for their preparedness to following practical experience with real patients. In terms of clinical procedures, students` confidence rated by 5-point Likert scale increased from 2.6 into 3.7 and it improved by 0.9 for physical exam through the workshop. The degree of their needs for clinical skills lab remained high before and after the workshop. Majority of student and faculty remarks on the training workshop were highly positive. The most important component for the successful introduction of clinical skills lab is the change in the mindsets of teachers and learners. The clinical skills lab is not only an efficient way for the medical students to prepare and refine their immature clinical skills but also sometimes only way to learn how to solve the challenges in such a critical situation as intensive care unit. The commitment of dean of a medical school and a consistent strategy to put higher priority on the provision of highly organized opportunity to practice essential clinical skills to medical students are two wheels of the program. However clinical skills lab is not designed to replace clinical experiences but to provide additional opportunities for students to strengthen clinical skills in patient management. A study to validate these instructional tools should be undertaken and total quality management system needs to be operated from the beginning stage. The effectiveness of these educational methods can be assessed by competency-based exams using simulated or real situations. Even though surgical skills can be trained through the same process benefits for learners should be verified further. Clinical skills lab should not be regarded as a panacea or the methods to rectify many problematic aspects of bedside teaching in Korean. What skills to be taught in clinical skills center must be selected both from learning objectives previously published and from the consensus meeting in a medical school. Linkage between clinical skills lab training with clinical clerkships may make this program more practical sense.