A study of pre-registration house officers' clinical skills

Background Little is known about the ability of preregistration house offic ers (PRHOs) to perform basic clinical skills just prior to entering the med ical register. Objectives To find out whether PRHOs have deficiencies in basic clinical sk ills and to determine if the PRHOs themselves or their consultants are awar e of them. Method All 40 PRHOs at the Chelsea and Westminster and Whittington Hospital s were invited to undertake a 17 station OSCE of basic clinical skills. Eac h station was marked by one examiner completing an overall global score aft er completing an itemised checklist. An adequate station performance was th e acquisition of a pass/borderline pass grade. Prior to the OSCE, a questio nnaire was given to each PRHO asking them to rate their own abilities (on a 5-point scale) in the skills tested. A similar questionnaire was sent to t he educational supervisors of each PRHO asking them to rate their house off icer's ability in each of the same skills. Results Twenty-two PRHOs participated. Each PRHO failed to perform adequate ly a mean of 24 OSCE stations (SD 1.8, range 1-8). There were no significan t correlations between OSCE performance and either self- or educational sup ervisor ratings. The supervisor felt unable to give an opinion on PRHO abil ities in 18% of the skills assessed. Discussion This study suggests that PRHOs may have deficiencies in basic cl inical skills at the time they enter the medical register. Neither the PRHO s themselves nor their consultants identified these deficiencies. A large r egional study with sufficient power is required to explore the generalizabi lity of these concerns in more detail.