No abstract available.
Clinical Competence*

Background and Objective: Teaching clinical skills to undergraduate medical students has brought significant challenges during the COVID-19 pandemic. Patient discussion utilized hypothetical cases from history taking to diagnosis and management. Further, everything was delivered online. Target-Oriented Clinical Skill Enhancement (TOCSE) is a teaching and learning tool that integrates the basic medical sciences, such as anatomy, physiology, pathology, microbiology, and pharmacology, at the clinical level. TOCSE has been proven to improve the clinical performance of fourth-year medical students. However, clinical confidence remains an issue, especially for medical students on pure online mode of learning during the pandemic. Therefore, this study was undertaken to determine if TOCSE also facilitates the development of confidence in the clinical performance of 4th-year medical students during the first-time patient encounter after online undergraduate classes. Methods: Eight-item Clinical Performance Confidence Scale survey was performed at three (3) time points of fourth-year medical student’s rotation in the Department of Medicine: (1) prior to the deployment to the outpatient department (Pre-OPD), (2) after the first-time patient encounter without TOCSE workshop (Post-OPD no TOCSE), and (3) after the patient encounter with TOCSE workshop (Post-OPD with TOCSE). Mean and standard deviations were used to summarize the confidence level of the 4th-year medical students, based on the 10-point differential scale being 0 as not confident at all and 10 as very confident. Wilcoxon Signed Rank assessed improvements of confidence level from Pre-OPD to Post-OPD. Effect sizes were also calculated to compare the improvement in the items. All statistical tests were performed in SPSS version 26.0. P-values less than 0.05 indicate a significant increase in the confidence level of 4th-year medical students. Results: There is a significant increase in the clinical confidence of 4th-year medical students from Pre-OPD to Post-OPD no TOCSE (mean ± SD: 6.32 ± 1.02 to 7.06 ± 0.95, p<0.001). Comparing the eight items between Pre-OPD and Post-OPD with no TOCSE, performing a complete physical examination has the most remarkable improvement. Further, there is a significant increase in the clinical confidence of 4th-year medical students from Post-OPD no TOCSE to Post-OPD with TOCSE (mean ± SD: 7.06 ± 0.95 to 7.51 ± 0.89, p<0.001). The performance of a complete history-taking has the most considerable improvement (7.29 + 1.03 to 7.89 + 1.01, p<0.001). Correspondingly, the most significant increase in the clinical confidence of 4th-year medical students was seen among the Post-OPD with TOCSE compared to their Pre- OPD confidence scores (mean ± SD: 6.32 ± 1.02 to 7.51 ± 0.89, p<0.001). Among the eight items between Pre-OPD and Post-OPD with TOCSE confidence scores, the item on performing a complete physical examination has the most remarkable improvement (5.67 ± 1.37 to 7.20 ± 1.22, p<0.001), closely followed by performing a complete history-taking (6.53 ± 1.19 to 7.89 ± 1.01, p<0.001). The most significant improvements in clinical confidence were seen in all the items in the Post-OPD with TOCSE than in the Post-OPD with no TOCSE versus Pre-OPD confidence scores. In addition, with TOCSE, the number of medical students who scored 7.50 and above was amplified more than 3 times (17.4% to 58.7%, p<0.001, Pre-OPD vs. Post-OPD with TOCSE, respectively). Conclusion: Target-Oriented Clinical Skill Enhancement (TOCSE) effectively builds up confidence during first-time patient encounters among fourth-year medical students taught online with hypothetical cases during their undergraduate classes. Key words: Target-Oriented Clinical Skill Enhancement, clinical confidence, clinical skill, fourth-year medical students, medical undergraduate challenge, online teaching in COVID-19 pandemic
Clinical Competence

Introduction: During the COVID-19 pandemic, medical schools shifted to blended learning. This study aimed to determine the demographic and level of confidence of a private medical school’s clinical clerks of School Year 2021-2022 on general competencies and skills. Methods: The study aimed to identify the skills that exhibited the highest and lowest levels of confidence among a group of 139 clinical clerks. Additionally, it sought to examine whether there were significant differences in confidence levels based on sex and prior clinical experience. An analytical cross-sectional study design was employed using a Google Form as the data collection tool. Results: The clerks were most confident in handwashing, and least in NGT insertion, performing digital rectal examination (DRE), and suturing. Females were more confident in history taking of obstetric and gynecologic, surgical, and medical patients, physical examination of pediatric patients, and preparing a discharge summary, while males were more confident in performing digital rectal examination. Clerks with prior medical experience were significantly more confident in foley catheter insertion, intravenous insertion, blood extraction, suturing, and performing essential intrapartum and newborn care (EINC) than those without. The results aligned with previous studies since clerks with prior experience were able to practice the skills in a psychomotor sense. Conclusion The study revealed significant differences in the confidence level on the competencies and skills for medical practice between sex and prior medical experience.
Clinical Competence

An impairment is defined as "a loss, loss of use, or derangement of any body part, organ system or organ function". The impairment evaluation should be performed by physicians. To determine permanent impairment associated with medical condition a standard method should be used. It is a general principle that an evaluation of permanent impairment only be performed when the physician considers the person to have reached a state of maximum medical improvement. Maximum medical improvement is considered when the person's condition has been medically stable and is unlikely to change by more than 3% of whole body impairment within the next 12 months. The physician must use the entire clinical skill and judgment to perform the proper impairment evaluation. A report of the evaluation of permanent impairment should be accurate, comprehensive and fair. The physicians are reminded that they have a duty to act in an ethical, professional and considerate manner when examining the person for the purpose of assessing the permanent impairment.
Clinical Competence ; Humans ; Judgment

No abstract available.
Canada* ; Clinical Competence*

PURPOSE: This study was performed to identify the effects of self-leadership and job involvement on clinical competence in general hospital nurses. METHODS: The participants in this study were 443 staff nurses working in general hospitals and having more than 6 months of nursing experience. Data were collected using self-administered questionnaires. RESULTS: There were significant positive correlations between nurses' self-leadership and job involvement, and between nurses' self-leadership and clinical competence. In the multiple regression analysis, clinical career, type of department and self-leadership were significant predictors in explaining nurses' clinical competence and accounted for 28% of the variance in nurses' clinical competence. CONCLUSION: Study findings suggest that nurses' self-leadership is defined as having an important influence on nurses' clinical competence. In order to strengthen nurses' clinical competence, there is a need to develop education programs to increase nurses' self-leadership.
Clinical Competence ; Hospitals, General

No abstract available.
Clinical Competence ; Licensure

No abstract available.
Clinical Competence ; Licensure

No abstract available.
Clinical Competence ; Licensure ; Lifting

No abstract available.
Clinical Competence ; Licensure ; Lifting