[Acquisition of clinical observation skills by medical students improves with discipline-based teaching. The example of neurological examination].

Introduction: Since 2014-2015, practical teaching of clinical observation skills for 2 ^nd year medical students at our faculty has been discipline-based; previously, each clinical lecturer had to cover all medical fields. We assessed the impact of this teaching reform on the neurological examination skills of medical students in a before-and-after study.
Methods: Pre-reform 3 ^rd and post-reform 2 ^nd and 3 ^rd year medical students (n=62, n=71 and 52, respectively) had to perform 7 neurological examination items, for which performance criteria had been pre-defined. Subsequently, we assessed whether the mean grade in neurological examination skills during the test at the end of the 2 ^nd year was different between students who had received neurological teaching from a neurologist (n=29) or another specialist (n=102).
Results: The median [interquartile range] number of items acquired by post-reform 3 ^rd year students (4 [2-5]) was higher than that of pre-reform 3 ^rd year students (2 [1-3]; P<0.001), but lower than that of post-reform 2 ^nd year students (5 [4-6]; P=0.01). The mean grade obtained during the practical test was not different in students trained by a neurologist or another specialist.
Conclusion: Acquisition of neurological examination skills improved after the teaching reform which consisted of: (1) a discipline-based practical teaching of clinical observation skills; (2) a training of clinical lecturers to teach a limited list of educational objectives; and (3) the introduction of a practical test at the end of the 2 ^nd year of medical studies. However, there was a decline in clinical observation skills between 2 ^nd and 3 ^rd year medical students.
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