Tools used to assess medical students competence in procedural skills at the end of a primary medical degree: a systematic review

Abstract

The objective was to systematically review the literature to identify and grade tools used for the end point assessment of procedural skills (e.g., phlebotomy, IV cannulation, suturing) competence in medical students prior to certification. The authors searched eight bibliographic databases electronically – ERIC, Medline, CINAHL, EMBASE, Psychinfo, PsychLIT, EBM Reviews and the Cochrane databases. Two reviewers independently reviewed the literature to identify procedural assessment tools used specifically for assessing medical students within the PRISMA framework, the inclusion/exclusion criteria and search period. Papers on OSATS and DOPS were excluded as they focused on post-registration assessment and clinical rather than simulated competence. Of 659 abstracted articles 56 identified procedural assessment tools. Only 11 specifically assessed medical students. The final 11 studies consisted of 1 randomised controlled trial, 4 comparative and 6 descriptive studies yielding 12 heterogeneous procedural assessment tools for analysis. Seven tools addressed four discrete pre-certification skills, basic suture (3), airway management (2), nasogastric tube insertion (1) and intravenous cannulation (1). One tool used a generic assessment of procedural skills. Two tools focused on postgraduate laparoscopic skills and one on osteopathic students and thus were not included in this review. The levels of evidence are low with regard to reliability – κ = 0.65–0.71 and minimum validity is achieved – face and content. In conclusion, there are no tools designed specifically to assess competence of procedural skills in a final certification examination. There is a need to develop standardised tools with proven reliability and validity for assessment of procedural skills competence at the end of medical training. Medicine graduates must have comparable levels of procedural skills acquisition entering the clinical workforce irrespective of the country of training.

Medical Students’ Knowledge of Clinical Practical Procedures: Relationship with Clinical Competence

“…Alongside humanistic qualities, clinical competence is an attribute expected of every practicing doctor (Carr, 2004) while demonstration of proficiency and appropriate use of procedural skills pre-registration is a requirement by certifying bodies (Morris, Gallagher, & Ridgway, 2012).…”

Teaching the Simple Suture to Medical Students for Long-term Retention of Skill

“…[1][2][3][4] The objective structured assessment of technical skills (OSATS) is a validated checklist used for evaluation of competence in procedural skills that can be adapted for specific tasks, including wound closure. The OS-ATS has been used successfully to evaluate medical students performing laceration repair in a simulated environment.…”

Low-cost assessment tools for the development of psychomotor competency in procedural surgical skills

“…The push to move toward a truly evidence based medical system will depend on the ability to provide students with a set of core competencies that may be objectively assessed and improved upon. In an effort to move toward this goal, virtual reality platforms and physical training models are undergoing development and indepth investigation (Loukas et al, 2012;Morris et al, 2012;O'Connor and McGraw, 1997).…”