Clinicals skills training: two generations and two worlds apart Part One

Abstract

Objective. Here, we compare clinical skills training in the 20thand 21st centuries in two different countries, in order to underlineadvancements and principal obstacles. Methods. Theclinical training of medical students in the nineteen-sixties atthe Sarajevo School of Medicine, Yugoslavia, and contemporarytraining at one of Europe’s prestigious medical schools atHeidelberg University, Germany were analyzed with respect tothe organization of training, teaching tools, methods, and staff.Several issues were defined as unimproved over the course oftime, and we suggest that they present the core of the currentproblem. Results. Considerable advances have been made inteaching methodologies, tools and assessment of students. Themajor remaining obstacles are the institutional value system,poor motivation of teaching staff, curriculum structure, timing,and placement of training in the curriculum, as well as thepatients’ attitude towards participation in the training. Conclusions.In the process of bettering the existing training modelswe suggest acting along several lines. Increased institutionalawareness of obstacles, as well as willingness to develop theways and means to increase the motivation of the faculty, isimperative. Furthermore, it is necessary to introduce changesin the structure and timing of training and to complement itwith a Catalogue, Practicum and Portfolio of Clinical Skills.We believe that recognizing the impediments and employingthe proposed solutions could significantly improve the qualityof clinical skills training.