AN ACTIVE-LEARNING APPROACH TO BASIC CLINICAL SKILLS

Within the context of comprehensive changes in the preclinical curricu lum at Northwestern University Medical School, the authors sought to c reate an active-learning approach to teaching the basic clinical skill s of communication, physical examination, and diagnostic reasoning. Th is approach is built upon the premise that repetitive practice using a structured database, which is emphasized in traditional curricula, is necessary but not sufficient for students' early development as clini cians, as it marginalizes essential areas of discourse and restricts s tudents' understanding of the scope of the medical encounter. Accordin gly, this clinical skills curriculum incorporates small-group, patient -instructor, and peer-observation formats to encourage critical thinki ng and reflection. The clinical skills units have been among the most popular aspects of Northwestern's new curriculum. Preliminary data sug gest that the overall attitudes, knowledge, and clinical proficiency o f students completing this curriculum compare favorably with those of students who progressed through the preclinical curriculum before the active-learning approach was introduced.