Does clinical training in pediatrics improve med III students approach to children ?

Abstract

Background & Objective: Physical examination is the cornerstone for correct patient diagnosis. Examination of a pediatric patient requires additional skills related to patient– doctor interaction. Therefore, performing an accurate and complete physical examination of a child may be a challenging if not an impossible mission for unexperienced medical students during their pediatric internship. Having a pediatric-adjusted clinical approach might be the solution. Methods: A Cohort study was done in our university hospital "Notre Dame des Secours". All Med III students27 received a supplementary 3-hours presentation with instructional videos regarding pediatric physical exam (P/E) approach. This was followed by a Q/A session with a pediatric attending and 1-week rotation on the pediatric floor and pediatric ER. Pediatric residents supervised them during daily rounds and staff meetings. Students were afterwards asked to fill a questionnaire focusing on different pediatric physical exam skills. The same questionnaire was filled by the same medical students at the completion of their pediatric Med III scheduled rotation. The control group consisted of the Med III students29 - who did not receive the supplementary presentation – after completing their pediatric rotation. Control group was asked to fill the same questionnaire. We used the "Statistical Package for the Social Sciences" (SPSS) version 22 as a statistics analysis tool. Results: After comparing the two groups, 19.6 % and 39.3% OF Med III students in intervention group felt respectively that "if a child cries it is their fault (p=0.023) and that "the childs mother is always right until proven otherwise" (p=0.000) vs 7.1% and 14.3 % in controls. Regarding the childs comfort, the intervention group learned that" if the child is ticklish, their own hands can be used to palpate the abdomen" (p=0.000). However, questions regarding starting with ENT exam and using firm tone or skipping parts of examination were .