Effects of a supplementary final year curriculum on students' clinical reasoning skills as assessed by key-feature examination

Background: The final year of medical education is considered crucial in making students ‘fit for purpose’. Studies have shown that many students leave medical school without having experienced sufficient preparation for their upcoming professional life. Aim: The aim of this study was to examine the effectiveness of a supplementary internal medicine final year curriculum on clinical reasoning skills. Method: Final year internal medicine students from two universities participated in the study which was based on a static-group design. The experimental group (n ¼ 49) took part in a final year student curriculum with interactive case-based seminars and skills training sessions. The comparison group (n ¼ 25) did not receive any additional training beyond working on the ward. Clinical reasoning skills were assessed using a key-feature pre-post test. Results: Prior to their clinical rotation, the two groups did not differ in the key-feature examination ( p50.924). The experimental group performed significantly better than the comparison group ( p50.028) in the post-intervention key-feature examination. Conclusions: Supplementary interactive case-based seminars and skills training sessions are effective and significantly improve the clinical reasoning skills of final year students in internal medicine. Further study is warranted and should look to examine the effectiveness of a final year student curriculum on other performance measures.