J Educ Eval Health Prof.  2013;10:13.

Assessment of structured physical examination skills training using a retro-pre-questionnaire

• Piryani RM
• Shankar PR
• Piryani S
• Thapa TP
• Karki B
• Khakurel M
• Bhandary S

Abstract

PURPOSE
The effectiveness of physical examination skills (PES) training is very rarely assessed using the "post-then-pre" approach. In this study, a retro-pre-questionnaire was used to study the effect of structured physical examination skills training (SPEST) imparted to second-year undergraduate medical students.
METHODS
KIST Medical College (KISTMC) affiliated to Tribhuvan University Nepal admitted its first batch of MBBS students in November 2008. The university curriculum recommends the involvement of Medicine and Surgery Departments in PES training, but the methods for teaching and assessment are not well defined. KISTMC has made training more structured and involved the Medicine, Surgery, Gynaecology and Obstetrics, Orthopaedics, ENT, Ophthalmology, Paediatrics, and Family Medicine Departments. SPEST includes the teaching/learning of basic PES for 210 minutes once a week for 28 weeks. Self-assessment is done by using a retro-pre-questionnaire at the end of the last session of training, and these data are analysed using SPSS.
RESULTS
Out of 100 students, 98 participated in the objective structured clinical examination (OSCE); 82 completed the retro-pre-questionnaire. Forty-six skills representing various systems were selected for inclusion in the retro-pre-questionnaire from among the many skills taught in different departments. The average perceived skills score (maximum score, 46x4=184) before training was 15.9 and increased to 116.5 after training. The increase was statistically significant upon the application of a paired t-test.
CONCLUSION
The students perceived that their level of skills improved after the training. The retro-pre- instrument seems to be useful for assessing the learners' self-reported changes in PES after training if a large number of skills need to be assessed. However, it should be noted that although a retro-pre-questionnaire may reveal valuable information, it is not a substitute for an objective measure or gold standard.

Keyword

Assessment; Physical examination skills; Training

MeSH Terms

Curriculum
Humans
Methods
Nepal
Obstetrics
Ophthalmology
Physical Examination*
Self-Assessment
Students, Medical

Reference

1. Program Development and Evaluation. Using the Retrospective Post then-Pre Design, Quick Tips #27 [Internet]. Madison, WI:University of Wisconsin Extension; 2005 [updated 2005 Jul 25; cited 2013 Sep 17]. Available from: http://www.uwex.edu/ces/pdande/resources/pdf/Tipsheet27.pdf.

2. Piryani RM, Shankar PR, Thapa TP, Karki BM, Kafle RK, Khakurel MP, Bhandary S. Introduction of structured physical examination skills to second year undergraduate medical students. F1000Research. 2013; 2:16. http://dx.doi.org/10.12688/f1000research.2-16.v1.

3. Colosi L, Dunifon R. What’s the difference?: “post then pre” & “pre then post” [Internet]. New York: Cornell University Cooperative Extension; 2006[cited 2013 Sep 17]. Available from:http://www.human.cornell.edu/pam/outreach/parenting/research/upload/What-s-20the-20Difference-20Post-20then-20Pre-20and-20Pre-20then-20Post.pdf.

4. Zaidi Z, Zaidi SM, Razzaq Z, Luqman M, Moin S. Training workshops in problem-based learning: changing faculty attitudes and perceptions in a Pakistani medical college. Educ Health. 2010; 23:440. http://www.educationforhealth.net/text.asp?2010/23/3/440/101470.

5. Rockwell SK, Kohn H. Post-then-pre evaluation. J Ext. 1989; 27:2FEA5. http://www.joe.org/joe/1989summer/a5.php.

6. Davis GA. Using retrospective pre-post questionnaire to determine program impact. J Ext. 2003; 41:4TOT4. http://www.joe.org/joe/2003august/tt4.php/.

7. Raidl M, Johnson S, Gardiner K, Denham M, Spain K, Lanting R, Jayo C, Liddil A, Barron K. Use retrospective surveys to obtain complete data sets and measure impact in extension programs. J Ext. 2004; 42:2RIB2. http://www.joe.org/joe/2004april/rb2.php.

8. Lamb T. The retrospective pretest: an imperfect but useful tool . Eval Exchange. 2005; 11:18. http://www.hfrp.org/evaluation/theevaluation-exchange/issue-archive/evaluation-methodology/theretrospective-pretest-an-imperfect-but-useful-tool.