Misjudgment of Skills in Clinical Examination Increases in Medical Students Due to a Shift to Exclusively Online Studies during the COVID-19 Pandemic

• Published in: Journal of personalized medicine 2022-05, Vol.12 (5), p.781
• Main Authors: Lechner, Axel, Haider, Stefan P, Paul, Benedikt, Escrihuela Branz, Pablo F F, Felicio-Briegel, Axelle, Widmann, Magdalena, Huber, Johanna, Stadlberger, Ursula, Canis, Martin, Schrötzlmair, Florian, Sharaf, Kariem
• Format: Article
• Language: English
• Subjects: Blended learning; Classrooms; Core curriculum; Coronaviruses; COVID-19; Disease transmission; Internet; Medical students; Online instruction; Otolaryngology; Pandemics; Precision medicine; Questionnaires; Self evaluation; Severe acute respiratory syndrome coronavirus 2; Skill development; Skills; Statistical analysis; Teaching; Training
• ISSN: 2075-4426; 2075-4426
• DOI: 10.3390/jpm12050781

In medical school, practical capacity building is a central goal. During the COVID-19 pandemic, a shift to online teaching methods in university was mandated in many countries to reduce risk of SARS-CoV-2 transmission. This severely affected the teaching of psychomotor ability skills such as head and neck examination skills, resulting in a share of students that have only been taught such ENT-specific examination skills with online courses; our study aimed to measure performance and capacity of self-evaluation in these students. After completing a new extensive online Ear Nose Throat (ENT) examination course, we conducted a standardized clinical skills exam for nine different ENT examination items with 31 students. Using Likert scales, self-evaluation was based on questionnaires right before the clinical skills exam and objective evaluation during the exam was assessed following a standardized regime. Self-evaluation and objective evaluation were correlated. To compare the exclusive online teaching to traditional hands-on training, a historic cohort with 91 students was used. Objective examination performance after in-classroom or online teaching varied for single examination items while overall assessment remained comparable. Overall, self-evaluation did not differ significantly after online-only and in-classroom ENT skill teaching. Nevertheless, misjudgment of one's skill level increased after online-only training compared to in-classroom teaching. Highest levels of overestimation were observed after online training in simple tasks. While gender and interest in ENT did not influence self-evaluation and misjudgment, higher age of participants was associated with an overestimation of skills. Medical students with online-only training during the COVID-19 pandemic achieved similar ENT examination skills to those with traditional on-campus training before the pandemic. Nevertheless, students with online-only training were more prone to misjudge their skills when they assessed their skills. Due to the COVID-19 pandemic, current medical students and graduates might therefore lack individual specific psychomotor skills such as the ENT examination, underlining the importance of presence-based teaching.