Training for clinical skills in the 20th and 21st centuries: two generations and two worlds apart Part Two*

Abstract

Objective. Here, we compare clinical skills training in the20th and 21st centuries in two different countries, in order tounderline advancements and principal obstacles. Methods.The clinical training of medical students in the nineteensixtiesat the Sarajevo School of Medicine, Yugoslavia, andcontemporary training at one of Europe’s prestigious medicalschools at Heidelberg University, Germany were analyzedwith respect to the organization of training, teachingtools, methods, and staff. Several issues were defined as unimprovedover the course of time, and we suggest that theypresent the core of the current problem. Results. Considerableadvances have been made in teaching methodologies,tools and assessment of students. The major remaining obstaclesare the institutional value system, poor motivation ofteaching staff, curriculum structure, timing, and placementof training in the curriculum, as well as the patients’ attitudetowards participation in the training. Conclusions. In theprocess of bettering the existing training models we suggestacting along several lines. Increased institutional awarenessof obstacles, as well as willingness to develop the ways andmeans to increase the motivation of the faculty, is imperative.Furthermore, it is necessary to introduce changes in thestructure and timing of training and to complement it witha Catalogue, Practicum and Portfolio of Clinical Skills. Webelieve that recognizing the impediments and employing theproposed solutions could significantly improve the quality ofclinical skills training.