Integration of early clinical exposure into curriculum enhances self-assessment of professional competencies in medical practice

Medical education has predominantly adhered to a process-based education model. Recently, outcome-based education (OBE) has emerged as a dominant pedagogical framework, facilitating simultaneous acquisition of theoretical knowledge, practical skills, and clinical experience. In 2020, our medical school implemented a new curriculum designed to integrate clinical skills training and experiential learning with foundational knowledge from the first year. Herein, we evaluated whether the clinical competencies of New Curriculum Students (NCS) are superior to the clinical competencies of Traditional Curriculum Students (TCS). Specifically, we clarified how self-assessment scores related to competencies in "Professional practice skills" evolved over time, and analyzed the longitudinal trends in self-assessment scores. We included TCS enrolled between 2016 and 2019, and NCS enrolled between 2020 and 2023. Self-assessment of students' competencies in "Professional practice skills," a core component of our institution's competency framework, was conducted by online survey. Competency levels were categorized into Levels A, B, and C. The self-assessment scores of NCS were significantly higher than those of TCS across most competency domains of "Professional practice skills." The "Medical interview and physical examination" competency revealed that first-year NCS achieved scores equivalent to those of fourth-year TCS. These scores were either maintained or improved as students progressed in years. In the "Clinical skills" competency, NCS outperformed TCS at all levels from the first to the third year, and at Level A in the fourth year. In the "Medical record charting" competency, NCS achieved significantly higher scores than TCS across all levels during the first and second years. The early acquisition of clinical skills and exposure to clinical practice enabled students to consistently maintain high self-assessment scores. A curriculum design aligned with OBE appears to foster a heightened sense of self-efficacy among students. This approach is anticipated to facilitate a seamless transition into clinical responsibilities as future physicians.