Structured clinical observations: a method to teach clinical skills with limited time and financial resources.

OBJECTIVE To develop and implement a methodology to teach clinical skills to medical students in busy clinical settings. METHODS The Structured Clinical Observation (SCO) program with guidelines and observation sheets for history-taking, physical examination, and information-giving skills was created. Faculty development preceded SCO implementation for pediatric clerkship students at Jefferson Children's Health Center. SCO observation sheets were tabulated and faculty and student questionnaires were administered. RESULTS The mean number of observations per student was 6, with 368 observations done for 63 students. SCOs were highly rated as an educational tool by faculty and students. The impact of the SCO program on faculty ability to perform clinical duties was initially minimal, but increased over the year. Observations were used primarily for feedback, but did influence outpatient clinical faculty's evaluation of two thirds of the students. Only 50% of students reported being observed in other rotations. CONCLUSIONS SCOs are a feasible, inexpensive, qualitatively effective method of teaching clinical skills. The quantitative effect of SCOs on performance needs to be evaluated.