Misjudgment of Skills in Clinical Examination Increases in Medical Students Due to a Shift to Exclusively Online Studies during the COVID-19 Pandemic.
Axel Lechner, Stefan P Haider, Benedikt Paul, Pablo F F Escrihuela Branz, Axelle Felicio-Briegel, Magdalena Widmann, Johanna Huber, Ursula Stadlberger, Martin Canis, Florian Schrötzlmair, Kariem Sharaf
Author Information
Axel Lechner: Department of Otolaryngology, University Hospital, LMU Munich, Marchioninistrasse 15, 81377 Munich, Germany.
Stefan P Haider: Department of Otolaryngology, University Hospital, LMU Munich, Marchioninistrasse 15, 81377 Munich, Germany.
Benedikt Paul: Department of Otolaryngology, University Hospital, LMU Munich, Marchioninistrasse 15, 81377 Munich, Germany.
Pablo F F Escrihuela Branz: Department of Otolaryngology, University Hospital, LMU Munich, Marchioninistrasse 15, 81377 Munich, Germany.
Axelle Felicio-Briegel: Department of Otolaryngology, University Hospital, LMU Munich, Marchioninistrasse 15, 81377 Munich, Germany.
Magdalena Widmann: Department of Otolaryngology, University Hospital, LMU Munich, Marchioninistrasse 15, 81377 Munich, Germany.
Johanna Huber: Institute for Medical Education, University Hospital, LMU Munich, Pettenkoferstrasse 8a, 80336 Munich, Germany.
Ursula Stadlberger: Institute for Medical Education, University Hospital, LMU Munich, Pettenkoferstrasse 8a, 80336 Munich, Germany.
Martin Canis: Department of Otolaryngology, University Hospital, LMU Munich, Marchioninistrasse 15, 81377 Munich, Germany.
Florian Schrötzlmair: Department of Otolaryngology, University Hospital, LMU Munich, Marchioninistrasse 15, 81377 Munich, Germany.
Kariem Sharaf: Department of Otolaryngology, University Hospital, LMU Munich, Marchioninistrasse 15, 81377 Munich, Germany. ORCID
In medical school, practical capacity building is a central goal. During the COVID-19 pandemic, a shift to online teaching methods in university was mandated in many countries to reduce risk of SARS-CoV-2 transmission. This severely affected the teaching of psychomotor ability skills such as head and neck examination skills, resulting in a share of students that have only been taught such ENT-specific examination skills with online courses; our study aimed to measure performance and capacity of self-evaluation in these students. After completing a new extensive online Ear Nose Throat (ENT) examination course, we conducted a standardized clinical skills exam for nine different ENT examination items with 31 students. Using Likert scales, self-evaluation was based on questionnaires right before the clinical skills exam and objective evaluation during the exam was assessed following a standardized regime. Self-evaluation and objective evaluation were correlated. To compare the exclusive online teaching to traditional hands-on training, a historic cohort with 91 students was used. Objective examination performance after in-classroom or online teaching varied for single examination items while overall assessment remained comparable. Overall, self-evaluation did not differ significantly after online-only and in-classroom ENT skill teaching. Nevertheless, misjudgment of one's skill level increased after online-only training compared to in-classroom teaching. Highest levels of overestimation were observed after online training in simple tasks. While gender and interest in ENT did not influence self-evaluation and misjudgment, higher age of participants was associated with an overestimation of skills. Medical students with online-only training during the COVID-19 pandemic achieved similar ENT examination skills to those with traditional on-campus training before the pandemic. Nevertheless, students with online-only training were more prone to misjudge their skills when they assessed their skills. Due to the COVID-19 pandemic, current medical students and graduates might therefore lack individual specific psychomotor skills such as the ENT examination, underlining the importance of presence-based teaching.
