The effect of clinical exam on midwifery students` confidence in clinical skills

Introduction. The aim of medical education is to produce competent , caring physicians. Self-confidence is another attribute often considered desirable for physicians. Confidence is a key to developing the sense of quantity that has been long recognized as a desirable characteristics of physicians, and confidence has a subjective marker of competence, An analytic descriptive survey was carried out in order to determine the clinical skills of midwifery students at gynecology and effect of clinical exam on self confidence in clinical skills. Methods. The end year of the curriculum , during the years 1999-2001 , immediately before and after taking final exam, the 40 midwifery students were asked to complete a brief survey about their levels of confidence in their clinical skills. The survey used a ten-point rating scale for the students to indicate their levels of confidence in history taking, physical examination , interacting and communicating with patients ,clinical reasoning , and dealing with difficult patients . The students' clinical skills defined in three levels. (adequate, moderate , inadequate) Results. Findings of the study indicated that , their highest levels of confidence , both before and after the clinical exam , were in history taking and interacting/communicating with patients ,the lowest levels of confidence were in clinical reasoning , and dealing with difficult patients, and their levels of confidence in physical exam were moderate . There were statistically significant positive correlations between each area for which students rated their confidence level and students exam performances , as assessed by their total final exam scores , specially in clinical reasoning and dealing with difficult patients. Conclusion. It is important for us as medical educators to understand the circumstances under which an educational intervention such as clinical exam increases confidence in clinical skills, with the confidence in turn validated by improved performance in those skills.