UC Irvine

Objective

Following our preliminary study on junior medical students' comfort levels in performing the head and neck physical examination (H&NPE) before and after a department-led teaching session, we assessed the longitudinal effect of this session on students during the core clinical clerkship year, in which these skills were performed on real patients.

Design

Anonymous cross-sectional survey study as a follow-up to previous intervention.

Methods

Overall, 101 and 90 second-year medical students participated in an H&NPE teaching session 1 year before the current survey administration in 2 consecutive years. The same cohorts of students, as third years, were asked to rate their comfort levels (0-5-point Likert scale) in performing the H&NPE and the importance of otolaryngology rotations in medical school and primary care residency training.

Results

Of the 101 and 90 students, 53 and 46 medical students completed the follow-up survey in each respective year. For both classes, compared with before the teaching session, students reported an average comfort level of 2.8 (somewhat to moderately comfortable) in performing the complete H&NPE (p < 0.0001) during the core clinical clerkship year. Similar changes were observed for the individual ear, nose, mouth, and neck components of the examination (all p's < 0.0002). Students at follow-up reported statistically similar comfort levels when compared with immediately after the teaching session for the ear, oral cavity, and neck examinations.

Conclusion

The initial teaching session persistently improved medical students' comfort levels in performing the H&NPE, with some attrition in comfort levels with performing the nasal examination and complete H&NPE. An otolaryngologist-directed, practical educational intervention may permanently reinforce the acquisition of complex skills such as the H&NPE.