Perceptions of changes made to a clinical skills curriculum in a medical programme in South Africa : a mixed methods study

Background. In 2015, a medical curriculum review at the University of the Witwatersrand, Johannesburg, South Africa, identified too large a gap between the medical school-based teaching in the fourth year of the course and the hospital-based teaching in the fifth year, when students begin their clinical clerkships. A number of changes were made to the curriculum to improve the preparation of students for the expectations of the clinical setting.Objectives. To determine students’ perceptions of how well their clinical skills curriculum in the fourth year prepared them for their clinical clerkships in the fifth year.Methods. An exploratory mixed methods approach was used. Phase I was a narrative qualitative study. The data underwent qualitative analysis and the categories that emerged informed the development of a questionnaire for phase II. This was a cross-sectional, comparative, quantitative study comparing students taught in the new curriculum (2018; fifth-year students (n=299)) with those taught in the old curriculum (2018; sixth-year students (n=291)).Results. The fifth- and sixth-year students had response rates of 50% and 34%, respectively. The results showed a perception of improved preparation for clinical clerkship through the changed clinical skills training. The p-value for 14 of the 16 questions was ˂0.05, with a 95% confidence interval, indicating that the difference between the two cohorts was statistically significant. Conclusion. The new curriculum has resulted in a significant improvement in students’ perceived preparation for their clinical clerkships.