Medical Students’ Clinical Skills Do Not Match Their Teachers’ Expectations: Survey at Zagreb University School of Medicine, Croatia

Clinical skills and theoretical knowledge are two equally important parts of medical education (1). Lack of clinical skills is often a source of insecurity for physician and represents potential danger for the patient (2). Clinical skills in “traditionally oriented” medical schools are usually learned by watching what clinicians do, by interviewing and examining patients, and by presenting findings to a supervisor (3). Studies in teaching and learning in clinical settings found that clinical teaching is variable, unpredictable, immediate, and lacks continuity (4). Furthermore, faculty members do not always know what students do or how they actually perform, especially if assessment procedures are emphasizing assessment of cognitive skills (5,6). Although this problem is well known, core clinical skills that need to be mastered during undergraduate education are still not clearly defined (7). One of the objectives of currently undergoing Bologna Process in medical schools is to define a system of accreditation, certification, or comparable procedures, including theoretical curriculum as well as clinical skills (8). Lately, the Delphi method has been applied to the curriculum design process (9). It is a flexible method, not subject to geographical constraints, which uses iterated questionnaires distributed to an expert panel to reach consensus on selected topic. The aim of this study was to determine the level of self-assessed clinical skills of medical students graduating in the 2004-2005 academic year and compare them with the levels expected by their teachers and levels defined by the criterion standard proposed in the Delphi study (10). Factors that might be influencing students’ learning of clinical skills and teachers’ expectations were also analyzed.