Boosting clinical performance: the impact of enhanced final year placements

Background: This study follows on from a study that investigated how to develop effective final year medical student assistantship placements, using multidisciplinary clinical teams in planning and delivery. Aims: This study assessed the effects on objective structured clinical examination (OSCE) performance of the in-course enhanced “super-assistantship” placement introduced to a randomly selected sample of 2013–14 final year medical students at Leeds medical school. Methods: Quantitative data analysis was used to compare the global grades of OSCE stations between students who undertook this placement against those who did not. Results: There was a small overall improvement in the “super-assistantship” student scores across the whole assessment (effect size = 0.085). “Pre-op Capacity”, “Admissions Prescribing” and “Hip Pain” stations had small-medium effect sizes (0.226, 0.215, and 0.214) in favor of the intervention group. Other stations had small effect sizes (0.107–0.191), mostly in favor of the intervention group. Conclusions: The “super-assistantship” experience characterized by increasing student responsibility on placement can help to improve competence and confidence in clinical decision-making “in a simulated environment”. The clinical environment and multidisciplinary team must be ready and supported to provide these opportunities effectively. Further in-course opportunities for increasing final year student responsibility should be developed.