How to assess ‎clinical skills?‎

How does a student learn a practical or clinical skill?

Simpson's taxonomy of psychomotor skill development provides a framework for understanding the progression of motor skills acquisition. It consists of seven stages, ranging from simple to complex skills. Here are examples of each stage of psychomotor skill development for a medical student:

1. Perception: Recognizing stimuli and cues relevant to the task.

  Example: Identifying anatomical structures in a cadaver during dissection.

2. Set: Readying oneself for action, mentally preparing to perform a skill.

  Example: Mentally visualize the steps of a clinical procedure, such as placing an IV line, before actually performing it.

3. Guided Response: Following instructions and demonstrating the skill under guidance.

  Example: Practicing physical examination techniques under the supervision of a clinical preceptor, such as performing a neurological assessment.

4. Mechanism: Performing the skill with increasing proficiency and accuracy.

  Example: Mastering the technique of suturing through repetitive practice on simulation models or animal tissue.

5. Complex Overt Response: Executing the skill with coordination and efficiency.

  Example: Performing a complete physical examination on a patient, including inspection, palpation, percussion, and auscultation, systematically and thoroughly.

6. Adaptation: Modifying the skill based on changing circumstances or unexpected events.

  Example: Adjusting the approach to intubation based on the patient's airway anatomy or response to initial attempts.

7. Origination: Creating new variations or applications of the skill.

  Example: Innovating new surgical techniques or approaches based on research findings or clinical experience, such as developing a novel minimally invasive procedure.

These examples illustrate how medical students progress from basic perceptual abilities to advanced motor skills mastery for their training, following Simpson's taxonomy of psychomotor skill development.

Different methods

Here is a list of common assessment methods for assessing students' practical and clinical skills in health profession education.

1. Objective Structured Clinical Examinations (OSCEs): These are stations where students perform specific tasks under observation. 
2. Direct Observation of Procedural Skills (DOPS): An assessor observes students performing a procedure in a real clinical setting.
3. Mini-Clinical Evaluation Exercise (Mini-CEX): This involves direct observation and feedback of a clinical encounter.
4. Portfolios: These are collections of evidence of a student’s competence over time.