The rehearsal of clinical skills in sequence, through case-based scenarios

Abstract

First year clinical students in the Department of Veterinary Medicine of the University of Cambridge have timetabled sessions dedicated to task-based training using benchtop models in the Pauline Brown Clinical Skills Centre. Combined with self-directed skills rehearsal, this results in students well-practiced with the majority of available skills stations by the start of their second year of clinical studies. Rather than further rehearsal of isolated skills, these students require additional challenges. Additionally, whilst procedures taught out of context are a beneficial starting point for the inexperienced learner, continued practice in this way can misrepresent what is required in the clinical setting (1). Case-based scenarios were devised, each necessitating a series of procedural skills to be performed in sequence, as required in the clinical context. The scenarios include canine ovariohysterectomy, feline urethral obstruction and equine wound management. Additional dimensions of the simulations include clinical decision making, use of local documentation and simulated client communication. Students complete the scenarios with the supervision and assistance of teaching staff.

Each scenario was run across one cohort of second year clinical students. Students were asked for open comments on their experience, via an anonymous online feedback mechanism. Ninety-seven % of the responses (n=148) were positive, with 22% of these comments specifically citing the sequencing of clinical skills into a case-based context. Opportunities for further development of this approach in this setting will therefore now be sought, with continuing reference to the established medical literature on contextualized simulation and procedural skills.