Medical Students’ Knowledge of Clinical Practical Procedures: Relationship with Clinical Competence

Abstract

Clinical competence is an attribute expected of every practicing doctor while proficiency in procedural skills is a requirement by certifying bodies. To attain competency in the performance of procedural/psychomotor skills, possession of conceptual knowledge has been documented as a fundamental pre-requisite in reference to medical education literature. At the University Of Zambia School Of Medicine, the matter of cognitive knowledge in relation to competence in clinical practical skills for undergraduate medical students was investigated in a project which was conducted in 2013. Fifty-six (56) students from a class of 60 (93% response rate) of the final year medical students’ class of 2012/2013 completed a Multiple Choice Question (MCQ) knowledge test which was administered to ascertain the level of knowledge on 14 selected clinical practical procedures. Knowledge levels of clinical practical procedures of the final year medical students were found to be inadequate represented by a 39% pass rate with students’ scores lower than the Angoff determined pass mark on most items. Expectedly, students were more knowledgeable in those procedures where they were formally taught and those where there was a high likelihood of being assessed. The correlation between knowledge and self-perceived competence was positive Spearman rho of 0.360, while a negative correlation was recorded between knowledge and manifest competence (objectively measured competence) Pearson r – .116. The positive correlation between knowledge and self-perception of competence is an indication of the role of knowledge in improving self-concept about a skill, which may consequently lead to improved performance.