Oshiro Tsuyoshi, Suzuki Shintaro, Kagawa Naoki, Ono Himawari, Goto Rieko, Furuta Atsuko, Arima Makiko, Tsuchiya Shizuma, Ogata Hiroaki, Barroga Edward, Izumi Miki
Department of Medical Education, Showa Medical University School of Medicine, 1-5-8 Hatanodai, Shinagawa City, Tokyo, 142-8555, Japan.
International Exchange Center, Showa Medical University, 1-5-8 Hatanodai, Shinagawa City, Tokyo, 142-8555, Japan.
BMC Med Educ. 2025 Aug 2;25(1):1139. doi: 10.1186/s12909-025-07678-7.
Medical education has predominantly adhered to a process-based education model. Recently, outcome-based education (OBE) has emerged as a dominant pedagogical framework, facilitating simultaneous acquisition of theoretical knowledge, practical skills, and clinical experience. In 2020, our medical school implemented a new curriculum designed to integrate clinical skills training and experiential learning with foundational knowledge from the first year. Herein, we evaluated whether the clinical competencies of New Curriculum Students (NCS) are superior to the clinical competencies of Traditional Curriculum Students (TCS). Specifically, we clarified how self-assessment scores related to competencies in "Professional practice skills" evolved over time, and analyzed the longitudinal trends in self-assessment scores.
We included TCS enrolled between 2016 and 2019, and NCS enrolled between 2020 and 2023. Self-assessment of students' competencies in "Professional practice skills," a core component of our institution's competency framework, was conducted by online survey. Competency levels were categorized into Levels A, B, and C.
The self-assessment scores of NCS were significantly higher than those of TCS across most competency domains of "Professional practice skills." The "Medical interview and physical examination" competency revealed that first-year NCS achieved scores equivalent to those of fourth-year TCS. These scores were either maintained or improved as students progressed in years. In the "Clinical skills" competency, NCS outperformed TCS at all levels from the first to the third year, and at Level A in the fourth year. In the "Medical record charting" competency, NCS achieved significantly higher scores than TCS across all levels during the first and second years.
The early acquisition of clinical skills and exposure to clinical practice enabled students to consistently maintain high self-assessment scores. A curriculum design aligned with OBE appears to foster a heightened sense of self-efficacy among students. This approach is anticipated to facilitate a seamless transition into clinical responsibilities as future physicians.
医学教育主要遵循基于过程的教育模式。最近，基于结果的教育（OBE）已成为一种占主导地位的教学框架，有助于同时获取理论知识、实践技能和临床经验。2020年，我们医学院实施了一门新课程，旨在将临床技能培训和体验式学习与一年级的基础知识相结合。在此，我们评估了新课程学生（NCS）的临床能力是否优于传统课程学生（TCS）的临床能力。具体而言，我们阐明了与“专业实践技能”能力相关的自我评估分数如何随时间演变，并分析了自我评估分数的纵向趋势。
我们纳入了2016年至2019年入学的TCS以及2020年至2023年入学的NCS。通过在线调查对学生在“专业实践技能”（我们机构能力框架的核心组成部分）方面的能力进行自我评估。能力水平分为A、B、C三级。
在“专业实践技能”的大多数能力领域，NCS的自我评估分数显著高于TCS。“医学问诊和体格检查”能力显示，一年级的NCS取得的分数与四年级的TCS相当。随着学生年级的升高，这些分数保持不变或有所提高。在“临床技能”能力方面，NCS在第一年至第三年的所有水平上均优于TCS，在第四年的A级水平上也是如此。在“病历书写”能力方面，NCS在第一年和第二年的所有水平上取得的分数均显著高于TCS。
早期获得临床技能和接触临床实践使学生能够持续保持较高的自我评估分数。与OBE相一致的课程设计似乎能增强学生的自我效能感。预计这种方法将有助于学生顺利过渡到未来医生的临床职责中。
