Practice Doesn't Make Perfect: Clinical Experience With Procedures Does Not Correlate Well With Competence in Third-Year Medical Students.

ABSTRACT

OBJECTIVE: There is limited data available about factors which promote competence with procedures in medical students. Specifically, the relationship between procedural clinical experience and performance on an assessment is unclear. We sought to determine whether a correlation exists between the amount and type of clinical experience with a procedure and student performance on a standardized assessment of that procedure. DESIGN: Faculty performed standardized assessments of third-year medical students on ten procedures using simulation. We prospectively surveyed students about 3 types of experience (performed, observed, and simulated) with these procedures during their clerkships. We then analyzed whether a correlation exists between student experience and their competency assessment scores using Pearson's correlation. SETTING/PARTICIPANTS: Third-year medical students at the University of Kentucky College of Medicine. RESULTS: In 2018 to 2019, 131 students were assessed on procedural competency with 10 failures. One hundred and twenty students (91.6%) completed the clinical experience survey. Correlations between types of experience and competency scores were small to moderate, with only 5 of 40 being significant. We found no correlation between experience having performed a procedure and competency score. CONCLUSIONS: Overall, we did not find convincing evidence of a correlation between experience with procedures during clerkships and performance on a competency assessment. This suggests other factors may be contributing to procedural competence, which has implications for how educators should develop procedural competence in students.