Deliberate Practice: A Framework for boosting pre-clerkship clinical skills

Abstract Background Clinical skills performance is a core competence for medical students, yet many pre-clerkship students encounter significant challenges in applying clinical skills effectively during their transition to clinical rotations. This study aims to explore effective training frameworks and pedagogical approaches that enhance clinical skills performance, thereby facilitating the transition from preclinical to clinical clerkship and fostering the development of clinical competence. Methods A total of 157 pre-clerkship students graded in the 4th year were enrolled in this study. All the students underwent two-week enhanced performance training in clinical skills which focusing on medical history-taking, physical examination, and essential procedural skills. Two competence-based evaluations in the form of objective structured clinical examination (OSCE) were implemented before (OSCE-2) and after (OSCE-3) the enhanced performance training for the students. Additionally, OSCE scores of clinical diagnostic curricula (OSCE-1) which conducted two years ago were referred for comparison. Results The medical history-taking performance of pre-clerkship students demonstrated fine skills retention in the pre-training OSCE examination 79.50 (9.50) in OSCE-1 vs 79.50 (9.50) in OSCE-2, q = 1.767, p = 0.424. However, both performance of physical examination 95.10 (5.80) in OSCE-1 vs 85.00 (8.00) in OSCE-2, q = 15.840, p p p p p < 0.001 all showed significant improvement after the enhanced skills performance training. Conclusion The enhanced clinical skills performance training curriculum contributed to facilitate the transition from preclinical to clinical clerkship with improving skills performance. The aligned framework of deliberate practice and advanced teaching modalities showed significant effectiveness in the enhanced clinical skills performance training for pre-clerkship students, which providing reference to peers for best practices in evidence-based medicine education.