Evaluating a curriculum-embedded early clinical skills teaching program in a newly established Palestinian medical school: clinical- year students’ retrospective perceptions and a psychometric analysis
This study evaluates a curriculum-embedded early clinical skills program at a Palestinian medical school through a cross-sectional survey of 207 clinical-year students, revealing high perceived benefits for core clinical and communication skills alongside moderate barriers related to instructor variability and time constraints, while also validating a locally developed psychometric instrument for assessing such programs.
Original paper licensed under CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). This is an AI-generated explanation of the paper below. It is not written or endorsed by the authors. For technical accuracy, refer to the original paper. Read full disclaimer
The journey from the quiet safety of a classroom to the chaotic reality of a hospital ward is one of the most jarring transitions in a person's life. For medical students, this shift often happens abruptly, moving from memorizing textbooks to facing real patients who need answers, comfort, and physical examinations. In many parts of the world, this leap is so sudden that students feel unprepared, as if they have been handed the controls of a plane without ever having sat in the cockpit. To bridge this gap, educators have developed a strategy called early clinical skills teaching. This approach introduces students to the practical art of medicine—learning how to talk to patients, ask the right questions, and perform basic physical checks—long before they officially begin their hospital rotations. The goal is to let students practice these human interactions in a controlled environment, building confidence and competence before the stakes become life-or-death. While this method is common in wealthy nations, there has been very little research on how it works in places where resources are scarce and daily life is complicated by conflict and movement restrictions.
In a newly established medical school in Palestine, a researcher named Raghad Tanbour set out to understand how this early training actually felt to the students once they had already entered the hospital. The study focused on the Arab American University Palestine, a school that opened its doors in 2020 and integrated these early skills sessions into the first two years of its curriculum. Tanbour wanted to know if the students, now in their fourth, fifth, or sixth year of study, felt that this early practice had helped them. She also wanted to identify what stood in the way of the training being perfect. To find the answers, she asked 207 current medical students to fill out a confidential survey. These students had already experienced the full cycle of medical school, from their early classroom lessons to their current work with real patients, giving them a unique perspective on whether the early training had truly stuck.
The results painted a clear picture of a program that students found highly valuable, though not without flaws. The vast majority of respondents felt that the early training had significantly boosted their confidence. Specifically, they reported feeling much more sure of themselves when taking a patient's medical history and performing physical examinations. They also felt better equipped to communicate with patients, a skill that is just as critical as knowing medical facts. When asked to rate the benefits of the program on a scale from one to five, the students gave it an average score of 4.00, indicating a strong positive impression. The researchers also developed a new way to measure these feelings, testing a questionnaire to ensure it was reliable. The tool worked well for measuring the benefits, showing that the students' positive feelings were consistent across different questions.
However, the students were not entirely without criticism. While they loved the idea and the outcome, they pointed out specific hurdles that made the experience less than ideal. The most common complaints were not about a lack of access to patients or facilities, but rather about the consistency of the teaching itself. Students noted that the quality of the sessions varied depending on which instructor was leading them, leading to an uneven learning experience. They also felt that there simply was not enough time allotted for each topic to truly master the skills. On a scale measuring these barriers, the students gave a moderate score of 3.10, suggesting that while the program worked, it was hindered by logistical and instructional inconsistencies. Interestingly, the study found that a student's academic grades did not influence how they felt about the training; both high-achieving and average students saw the same value in the early skills sessions.
The data also revealed how the perception of this training changed as students progressed through their education. Those in their fourth year, who had just recently started their hospital rotations, felt the early training was the most beneficial, likely because they were immediately applying those skills in their new roles. By contrast, students in their sixth year, who were nearing graduation, were slightly more critical, perhaps because they had more experience to compare the early training against the demands of a full medical career. The study also looked at what kind of learning environment students preferred. Those who liked early exposure to real patients or even virtual reality simulations reported higher benefits than those who preferred working solely in a skills laboratory with mannequins. However, the group of students who preferred virtual reality was very small, so this finding is more of a hint for future research than a definitive rule.
Ultimately, this study suggests that introducing clinical skills early in medical education is a powerful tool for building confidence, even in a challenging environment like Palestine. The students confirmed that practicing communication and examination skills before entering the hospital made them feel more ready for the real world. Yet, the path to perfection requires attention to detail. The researchers concluded that to make these programs even better, schools need to ensure that every instructor teaches in a similar, high-quality way and that students are given enough time to practice each skill thoroughly. By focusing on standardizing the delivery of the lessons and protecting time for practice, medical schools can ensure that the bridge from classroom to clinic is not just a leap, but a steady, confident walk.
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