Author:
Dejene Daniel,Ayalew Firew,Yigzaw Tegbar,Woretaw Alemseged,Versluis Marco,Stekelenburg Jelle
Abstract
Abstract
Background
Ethiopia has scaled up medical education to improve access to healthcare which presented challenges to maintaining training quality. We conducted a study to assess the clinical competence of graduating medical students and the associated factors.
Methods and materials
A pretest assessment of a quasi-experimental study was conducted in 10 medical schools with a sample size of 240 students. We randomly selected 24 students per school. Clinical competence was assessed in a 12-station objective structured clinical examination. The clinical learning environment (CLE), simulation training, and practice exposure were self-rated. Mean scores for clinical competence, and satisfaction in the CLE and simulation training were calculated. Proportions of students with practice exposure, and who agreed on CLE and simulation items were done. Independent t-tests were used to look at competence differences among subgroups. Bivariate and multiple linear regression models were fitted for the outcome variable: competence score. A 95% statistical confidence interval and p-value < 0.05 were used for making statistical decisions. A 75% cut-off score was used to compare competence scores.
Results
Graduating medical students had a mean competence score of 72%. Low scores were reported in performing manual vacuum aspiration (62%), lumbar puncture (64%), and managing childbirth (66%). Female students (73%) had a significantly higher competence score than males (70%). Higher cumulative grade point average (CGPA), positive appraisal of the CLE, and conducting more clinical procedures were associated with greater competence scores. Nearly half of the students were not satisfied with the clinical practice particularly due to the large student number and issues affecting the performance assessment. About two-thirds of the students were not satisfied with the sufficiency of models and equipment, and the quality of feedback during simulation training. Nearly one-third of the students never performed lumbar puncture, manual vacuum aspiration, and venipuncture.
Conclusions
Medical students had suboptimal clinical competence. A better clinical learning environment, higher cumulative GPA, and more practice exposure are associated with higher scores. There is a need to improve student clinical practice and simulation training. Strengthening school accreditation and graduates’ licensing examinations is also a way forward.
Publisher
Springer Science and Business Media LLC
Reference54 articles.
1. Liu JX, Goryakin Y, Maeda A, Bruckner T, Scheffler R. Global health workforce labor market projections for 2030. In: Policy research working paper 7790. World Bank group; 2016. https://documents1.worldbank.org/curated/en/546161470834083341/pdf/WPS7790.pdf. Accesssed 2 Nov 2022.
2. Boniol M, Kunjumen T, Nair TS, Siyam A, Campbell J, Diallo K. The Global Health workforce stock and distribution in 2020 and 2030: a threat to equity and ‘universal’ health coverage? BMJ Glob Health. 2022;7:e009316. https://doi.org/10.1136/bmjgh-2022-009316.
3. GBD 2019 Diseases and Injuries Collaborators. Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the global burden of disease study 2019. Lancet. 2020;396:1204–22. https://doi.org/10.1016/S0140-6736(20)30925-9.
4. World Health Organization. Health workforce requirements for universal health coverage and the sustainable development goals. Human Resour Health Obs. 2016;17 https://apps.who.int/iris/handle/10665/250330. Accessed 5 Nov 2022.
5. World Health Organization. Global health observatory. In: The density of physicians (per 1,000 population). 2018. https://www.who.int/data/gho/indicator-metadata-registry/imr-details/3107. Accessed 5 Nov 2022.
Cited by
1 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献