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Med Teach. 2012;34(7):e500-7. doi: 10.3109/0142159X.2012.668627.

Impact of three alternative consultation training formats on self-efficacy and consultation skills of medical students.

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Ghent University, Gent, Belgium.



Conducting a consultation is a core competence of medical professionals. Consultation training of medical students centers on clinical, communication, reasoning and reflection skills. The training incorporates practice with a standardized simulated patient and supervising physician, to prepare for real patient encounters. To meet the request for more training, while dealing with an increasing student population and limited staff availability, alternative formats of consultation training were developed and evaluated.


To investigate the impact of three consultation training formats on students' self-efficacy beliefs and their consultation skills acquisition. The three formats comprised (1) traditional training with supervising physician, (2) autonomous training with feedback from simulated patients and peers, without direct supervision and (3) online training based on video fragments and answering guiding questions.


A quasi-experimental pre/posttest study was set up, with random assignment of students to a training condition. The differential impact was tested on two dependent measures: self-efficacy and consultation performance. Self-efficacy was tested with a nine-item scale and the cognitive component of consultation performance was tested on the base of responses to a standardized video case.


The autonomous training has a significant positive effect on students' self-efficacy (p=0.016). The traditional training and the online training did only positively influence the cognitive component of the consultation competence (p<0.001 and p=0.003).


Each consultation training contributes to the learning process in a different way. In order to achieve optimum learning effects, medical educators should be aware of the particular impact of specific trainings on the cognitive and motivational side of skills and pursue a balanced mixture of instructional formats.

[Indexed for MEDLINE]

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