Transfer of medical students' clinical skills learned in a clinical laboratory to the care of real patients in the clinical setting: the challenges and suggestions of students in a developing country.

CONTEXT: Recent studies indicate that medical students may face problems applying clinical skills taught in a skills laboratory setting when they enter their clerkships. This study explores these problems in the context of a developing country, and explores students' suggestions for improving clinical skills training.
METHODS: Focus groups discussions (FGDs) were organized with students who had just entered their clerkships. Transcripts of FGDs were digested according to the inductive content analysis protocol.
RESULTS: Clerkship students said to have encountered significant problems when they had to perform clinical skills on patients for the first time, in particular with respect to invasive clinical procedures. Differences in context between skills laboratory and clinic, inadequate supervision and unpredictable responses by patients were most common reasons given. Students suggested creating opportunities to practice clinical skills on patients before entering the clerkships.
CONCLUSION: Early in their clerkships students may face significant problems when they have to apply skills learned in the skills laboratory on actual patients. Particularly in developing countries, opportunities may exist to follow up on our students' suggestion to arrange for skills training of pre-clinical students in clinical settings.