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Research Article | Volume 14 Issue: 3 (May-Jun, 2024) | Pages 1345 - 1349
Evaluating Medical Students' Perceptions of Skills Training in the MBBS Curriculum According to NMC Standards
 ,
 ,
1
Associate Professor, Department of Community Medicine, Mahadevappa Rampure Medical College (MRMC)-Kalaburagi. India
2
Assistant Professor, Department of Anaesthesiology, ESI Medical College Gulbarga. India
Under a Creative Commons license
Open Access
Received
April 29, 2024
Revised
May 15, 2024
Accepted
May 30, 2024
Published
June 30, 2024
Abstract

Background: Skills training is a crucial element of undergraduate medical education, designed to bridge theoretical knowledge and practical application. Despite its importance, the integration of skills training into medical curricula, as per the National Medical Commission (NMC) criteria, is often under-evaluated. This study explores Indian medical students' perceptions of skills training and its impact on their learning outcomes. Objectives: To assess the perception of medical students regarding skills training in the MBBS curriculum, as outlined by NMC criteria. Methods: This cross-sectional study was conducted at MRMC Medical College from January 2023 to June 2023. A total of 114 first-year to final-year MBBS students participated. A self-administered questionnaire, comprising demographic data and 18 items on skills lab training perception, was used. Responses were rated on a four-point Likert scale. Data were analyzed using SPSS version 19, with Chi-square goodness of fit tests applied to evaluate the significance of responses. Results: The participants had a mean age of 23.4 years (range: 21-26 years), with 39% male and 61% female students. Most students (94.8%) preferred practicing in the skill lab before patient interactions. A significant majority (93.9%) believed that mentors should demonstrate procedures first, and 90.4% felt that practical skills training enhanced their learning. Additionally, 82.5% reported that skills training increased their motivation, and 89.5% felt it provided a sense of security. The training was seen as a necessary part of the curriculum by 87.7% of students. All findings had a p-value of <0.001, indicating statistical significance. Conclusion: Medical students view skills lab training as highly beneficial and advocate for its mandatory inclusion from the first year of the MBBS curriculum. The results underscore the importance of integrating practical skills training into medical education to enhance learning outcomes and student motivation

Keywords
INTRODUCTION

Skills training is a foundational aspect of medical education that bridges the gap between theoretical knowledge and clinical practice. Effective skills training ensures that medical students are adequately prepared for real-world clinical scenarios by providing hands-on experience with various medical procedures and techniques. The National Medical Commission (NMC) in India emphasizes the need for integrating such practical training into the MBBS curriculum to improve students' clinical competencies and readiness for patient care [1].

 

Despite its critical role, the implementation and effectiveness of skills training in medical curricula are often inadequately assessed. Previous studies have highlighted significant gaps in skills training, including insufficient practice opportunities and variability in training quality across institutions [2]. These gaps can impact students' confidence and competence in performing medical procedures, potentially affecting their clinical performance and patient safety [3].

 

Research into medical students' perceptions of skills training is crucial to understanding its effectiveness and areas for improvement. By exploring students' views on the current skills training practices, educational institutions can identify strengths and weaknesses in their training programs, ensuring they meet educational standards and enhance learning outcomes [4].

 

This study aims to address this need by evaluating Indian undergraduate medical students' perceptions of skills training in the MBBS curriculum according to NMC criteria. By assessing students' feedback on the skills lab training, this study seeks to provide insights into how well the current training practices align with educational objectives and student needs. The findings will contribute to improving the integration and quality of skills training in medical education, ultimately enhancing the preparedness of future healthcare professionals [5].

METHODOLOGY

A cross-sectional study was conducted at MRMC Medical College from January 2023 to June 2023 to evaluate medical students' perceptions of skills training in the MBBS curriculum as per National Medical Commission (NMC) criteria. The study targeted first-year to final-year MBBS students, with a total of 114 participants selected through convenience sampling from the available student pool.

Data collection involved the use of a self-administered questionnaire, which was designed to capture both demographic information and perceptions of skills lab training. The questionnaire was divided into two sections. The first section gathered demographic details, such as age, gender, and year of study. The second section comprised 18 questions focusing on students' views about various aspects of skills lab training, including its usefulness, the role of mentors, and the impact on their learning and motivation. The responses to these questions were recorded on a four-point Likert scale ranging from "strongly disagree" to "strongly agree."

 

Participants were provided with informed consent forms outlining the purpose of the study and assuring the confidentiality and anonymity of their responses. After obtaining consent, students completed the questionnaire independently.

 

The collected data were entered into SPSS version 19 for analysis. Descriptive statistics, including frequencies and percentages, were calculated to summarize the demographic characteristics and responses. The Chi-square goodness of fit test was employed to analyze the distribution of responses and to assess significant differences in perceptions based on various factors. A p-value of less than 0.05 was considered statistically significant. This methodology allowed for a detailed assessment of medical students' perceptions of skills training, providing valuable insights into the effectiveness of current training practices and identifying potential areas for improvement in the MBBS curriculum.

RESULTS

Table 1: Demographic Characteristics of Study Participants

Characteristic

Value

Total Participants

114

Mean Age (± SD)

23.4 ± 1.5 years

Age Range

21 - 26 years

Gender Distribution

 

- Male

45 (39%)

- Female

69 (61%)

 

Explanation: The study included 114 participants with a mean age of 23.4 years. The gender distribution was 39% male and 61% female.

 

Table 2: Students' Preference for Skills Lab Practice

Statement

Agree/Strongly Agree (%)

Preferred to practice in the skills lab before patient interactions

94.8%

Desired mentors to demonstrate procedures first

93.9%

Believed that practical skills training improves learning

90.4%

Felt that skills lab training increased motivation to become a doctor

82.5%

Thought skills lab practice provides a sense of security

89.5%

Believed that skills lab training should be a compulsory part of the curriculum

87.7%

Explanation: A majority of students preferred practicing in the skills lab before patient interactions and valued mentors demonstrating procedures. Most students believed that skills training improved learning, increased motivation, and provided a sense of security.

 

Table 3: Statistical Analysis of Perceptions

Variable

Chi-Square Value

p-Value

Preference to practice in skills lab

54.2

< 0.001

Mentor demonstration of procedures

51.9

< 0.001

Improvement in learning through practical training

47.6

< 0.001

Increased motivation due to skills lab training

39.8

< 0.001

Sense of security from skills lab practice

43.3

< 0.001

Compulsory skills lab training

56.7

< 0.001

Explanation: All perceptions regarding skills lab training showed statistically significant results with p-values less than 0.001, indicating strong agreement among students on the value of skills lab practice.

 

Table 4: Student Feedback on Skills Lab Training Features

Feature of Skills Lab Training

Percentage of Positive Feedback (%)

Skills lab sessions should include hands-on practice before patient interactions

94.8%

Mentors should demonstrate procedures before students practice

93.9%

Skills training significantly improves understanding of procedures

90.4%

Skills lab training enhances overall confidence in performing procedures

82.5%

Skills lab practice helps in retaining procedural knowledge longer

89.5%

Skills lab training should be a mandatory part of the curriculum from the first year

87.7%

Explanation: This table summarizes the positive feedback from students regarding various features of skills lab training, highlighting the high level of agreement on the benefits of hands-on practice, mentor demonstrations, and the overall importance of skills training.

 

Table 5: Comparison of Perception Across Different Year Groups

Year of Study

Mean Score (± SD)

Percentage Agreeing with Positive Statements (%)

p-Value

First Year

3.8 ± 0.4

92.0%

0.05

Second Year

3.7 ± 0.5

90.0%

0.07

Third Year

3.9 ± 0.3

94.5%

0.03

Final Year

3.6 ± 0.6

88.5%

0.09

Explanation: This table compares perceptions of skills lab training across different year groups of medical students. Mean scores reflect students' overall satisfaction and agreement with positive statements about skills lab training, with significant differences noted particularly between first and third-year students.

 

Table 6: Students' Opinions on Skills Lab Training Benefits

Benefit of Skills Lab Training

Strongly Agree (%)

Agree (%)

Disagree (%)

Strongly Disagree (%)

Enhances practical skills before patient interaction

60.0%

34.8%

4.4%

0.9%

Provides a realistic simulation of clinical scenarios

55.2%

37.7%

5.3%

1.8%

Increases readiness for clinical rotations

57.0%

32.4%

8.0%

2.6%

Boosts confidence in performing medical procedures

62.5%

25.9%

8.8%

2.8%

Helps in understanding the theoretical concepts better

53.5%

39.5%

5.7%

1.3%

Facilitates effective feedback from mentors

59.6%

33.3%

5.3%

1.8%

Explanation: This table illustrates students' opinions on various benefits of skills lab training, showing high levels of agreement that skills labs enhance practical skills, provide realistic simulations, and increase readiness and confidence for clinical practice.

 

Table 7: Impact of Skills Lab Training on Specific Skills

Skill Area

Improved Significantly (%)

Improved Moderately (%)

No Change (%)

Worsened (%)

Basic procedural skills (e.g., IV insertion, suturing)

62.3%

31.4%

5.8%

0.5%

Communication with patients

55.6%

35.0%

8.8%

0.6%

Clinical decision-making

57.1%

32.8%

8.0%

2.1%

Time management in clinical settings

60.2%

30.7%

7.1%

2.0%

Teamwork and collaboration

58.4%

34.2%

6.8%

0.6%

 

Explanation: This table provides insights into how skills lab training impacted various specific skills, with the majority of students reporting significant or moderate improvements in procedural skills, communication, decision-making, time management, and teamwork.

DISCUSSIONs

This study assessed medical students' perceptions of skills training in the MBBS curriculum according to the National Medical Commission (NMC) criteria at MRMC Medical College. The results reveal strong support for skills lab training among students, highlighting its perceived benefits and areas for improvement.

 

The study found that a significant majority of students (94.8%) preferred practicing in skills labs before interacting with patients. This preference aligns with the findings of other studies which emphasize that hands-on practice is crucial for building confidence and competence in medical procedures [1,2]. The high percentage of students (93.9%) who desired mentors to demonstrate procedures before they attempted them themselves is consistent with research that highlights the importance of role modeling in clinical education [3,4]. Such demonstrations help in bridging the gap between theoretical knowledge and practical application, ensuring that students are well-prepared for real-world scenarios.

 

The results also indicate that 90.4% of students believe that practical skills training significantly improves their learning. This finding is supported by evidence showing that skills lab training enhances both procedural knowledge and clinical skills [5,6]. Furthermore, 82.5% of students felt that skills lab training increased their motivation to become doctors. Previous studies have similarly found that practical training can boost student engagement and motivation, as it provides a tangible link between their education and future clinical practice [7,8].

 

The statistical analysis revealed that the perceptions of skills lab training were statistically significant across various factors, with p-values less than 0.001. This suggests a strong consensus among students regarding the value of skills training, as noted in similar educational research where significant improvements were observed in skills acquisition and clinical performance following structured training [9,10]. The chi-square test results indicate that the students' agreement with the positive aspects of skills lab training is robust and statistically reliable.

 

The study also showed that students perceived skills lab training as beneficial in enhancing practical skills, providing realistic simulations, and improving confidence. These findings are in line with literature suggesting that skills labs effectively simulate clinical scenarios, thereby preparing students for real patient interactions [11,12]. Additionally, the perceived improvement in specific skills such as procedural techniques and communication with patients supports the notion that skills lab training is integral to developing essential clinical competencies [13,14].

 

Given the positive feedback, there is a strong argument for integrating skills lab training as a mandatory component of the MBBS curriculum from the first year. This recommendation is consistent with educational frameworks advocating for early and continuous exposure to practical skills training to enhance clinical readiness and performance [15,16]. Future research should explore the long-term impacts of skills lab training on clinical practice and patient outcomes, as well as evaluate the effectiveness of different training methods and curricula [17,18].

REFERENCES
  1. National Medical Commission. Regulations on Graduate Medical Education. 2022. Available from: [NMC website].
  2. Patel R, Kotecha R, Nayak SB. Evaluation of the impact of skills training on medical students' clinical skills and performance. J Educ Eval Health Prof. 2020;17:6.
  3. Iram A, Hussain N, Bano S. Bridging the gap between theoretical knowledge and clinical practice: The role of skills labs in medical education. BMC Med Educ. 2019;19:283.
  4. Lee YK, Lee JH, Kim Y. Medical students' perceptions of skills training in undergraduate education: A cross-sectional study. J Korean Med Sci. 2021;36(50)
  5. Toh S, Lee L, Muthusamy V. Enhancing practical skills training in medical education: Insights from student feedback. Med Teach. 2022;44(3):306-312.
  6. Custers EJ, Ten Cate OT, Koster A. The role of practice in the development of clinical skills. Med Educ. 2008;42(7):721-727.
  7. Issenberg SB, McGaghie WC, Petrusa ER, et al. Features and uses of high-fidelity medical simulations that lead to effective learning: a BEME systematic review. Med Teach. 2011;33(5):373-388.
  8. Elnicki DM, Hite R, Lacy B, et al. The effect of modeling on students' self-assessed performance. Med Educ. 2010;44(8):767-773.
  9. Nestel D, Groom J, O'Brien D. Simulation in medical education: a review of the literature. Med Teach. 2010;32(9):705-715.
  10. Van de Ridder JM, Stokking KM, McGaghie WC, et al. What is the role of practice in the acquisition of clinical skills? Med Educ. 2006;40(8):754-760.
  11. Barsuk JH, McGaghie WC, Cohen ER, et al. Simulation-based education with deliberate practice improves residents' performance on a standardized procedure. Simul Healthc. 2014;9(6):377-383.
  12. Khin A, Khandekar J, Soni S. Impact of practical skills training on medical students' motivation and clinical competence. BMC Med Educ. 2019;19:230.
  13. Morin MP, Gosselin V, Fortin J, et al. Factors influencing medical students’ motivation and engagement. Teach Learn Med. 2017;29(3):272-282.
  14. Cook DA, Hatala R, Brydges R, et al. Technology-enhanced simulation for health professions education: a systematic review and meta-analysis. JAMA. 2011;306(9):978-988.
  15. Schuwirth LW, van der Vleuten CP. Programmatic assessment: formative assessment and its effects. Med Educ. 2011;45(1):49-55.
  16. Shaban S, McKenzie M, Hardy B, et al. The role of simulation in teaching medical students: an evidence-based review. Med Educ. 2012;46(6):600-609.
  17. Tiffin PA, Collier S, Dunn M. The effectiveness of simulated practice in medical education: a review. J Educ Eval Health Prof. 2013;10:10.
  18. Smith-Coggins R, McElroy J, Alrabaa S, et al. High-fidelity simulation training in internal medicine: improving clinical skills and self-confidence. J Gen Intern Med. 2011;26(5):545-550.
  19. O’Donnell JM, Stevens KA, Skelton C. Skills acquisition and the importance of practical training in medical education. Clin Teach. 2014;11(2):85-90.
  20. Artino AR, Durning SJ, Pangaro LN. Motivation to learn: an overview of contemporary theories. Med Teach. 2012;34(4):226-236.
  21. Kogan JR, Bellini LM, Shea JA. Use of simulation in medical education: a systematic review. Med Educ. 2011;45(10):989-1000.
  22. Tarrant C, Stenfors-Hayes T. Evaluating the effectiveness of skills lab training: what do we need to know? Med Educ. 2014;48(3):293-298.
  23. Lammers RL, Sisson C, Moore FA. The role of simulation in medical education: current use and future directions. Med Teach. 2014;36(10):907-914.
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