Developing knowledge and clinical competency in a respiratory system-based practice of final-year medical students through a novel structured bedside teaching module

摘要

Background: Respiratory diseases are a major cause of mortality and morbidity worldwide. A sound knowledge of management of respiratory diseases is thus very vital. The clinical exposure of undergraduate medical students is limited to 2 weeks in pulmonary medicine. We hypothesized that the short duration of posting can be best utilized by developing need-based modules for bedside teaching. Aims: This study aimed to determine gain in knowledge and skills of final-year medical students in diagnosis and management of common pulmonary diseases and assess students' perception of the module. Methods: A one-group pretest-posttest quasi-experimental study design enrolled a convenience sample of 48 final-year medical students. Twenty-four students were posted at a given time for the bedside clinical posting in pulmonary medicine between August 2013 and November 2013. These students were divided randomly into two groups of 12 students each. All students consented to be part of the study. Two trained faculty taught in rotation. The bedside teaching module was prepared by Delphi technique and curriculum was based on Kern's six-step approach. History taking, physical examination, tuberculosis, chronic obstructive pulmonary disease, asthma, lung cancer, chest X-rays, and spirometry were taught. Students were administered pre- and post-test questionnaires to assess knowledge, while Objective Structured Clinical Examination assessed skills. Students' feedback questionnaire evaluated the teaching module. A two-tailed paired sample t -test assessed mean gain in knowledge and skills. Effect size was calculated by Cohen's d, while Cronbach's alpha estimated the reliability testing of perception questionnaire. Statistical analysis was performed using statistical software package IBM SPSS version 23. Results: Mean pre- and posttest knowledge scores were 12.46 (8.09) and 43.17 (10.7), respectively, P = 0.001. Mean pre- and posttest skills scores were 7.00 (4.76) and 24.79 (3.31), respectively, P = 0.001, and Cohen's d showed large effect size. Most students stated that the module enhanced their clinical skills, helped to understand difficult material, and promoted inquiry and thinking. Cronbach's alpha for perception questionnaire was 0.854. Conclusions: Structured bedside teaching module in pulmonary medicine improved the knowledge and skills of undergraduate medical students. The contents and various teaching methodologies were evaluated positively.