Medical Students' Comfort Levels With Performing the Basic Head and Neck Examination in Practice: Follow-up During the Core Clerkship Year

OBJECTIVE: Following our preliminary study on junior medical students' comfort levels in performing the head and neck physical examination (H&ENPE) 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&ENPE 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&ENPE, with some attrition in comfort levels with performing the nasal examination and complete H&ENTE. An otolaryngologist-directed, practical educational intervention may permanently reinforce the acquisition of complex skills such as the H&NPE. (C) 2014 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.