Assessment of students' clinical skills in Primary Care

Abstract

Introduction The Brazilian medical undergraduate curriculum mandates a compulsory rotation in Primary Health Care (PHC), which calls for an understanding of the assessment modalities for acquired clinical competencies. Objectives: The study aims to identify the currently employed methods for evaluating clinical skills in the PHC setting, contributing to a comprehensive medical education. Method: A systematic review was conducted across PubMed, Medline, LILACS, SciELO, and Portal Capes databases, encompassing articles written in English, Portuguese, and Spanish, utilizing the following descriptors: “Clinical Competence”, “Medical Student”, and “Primary Health Care”. 743 quantitative and qualitative studies were identified, 40 selected for full-text reading and 24 ultimately for analysis. Results: Among 24 analyzed studies, 12 evaluated methodologies employing real patients, and 12 others discussed evaluations involving simulated patients. OSCE was the most employed in simulated patient scenarios, while in real patient scenarios, the checklist, teacher feedback, and direct observation were noteworthy. OSCE allows standardized evaluation, but its implementation proves resource-intensive. Assessment involving actual patients cannot be fully replicated, and checklists and direct observation to mensurate the acquired skills. Final considerations: The evaluation methods were diverse, however, Feedback stands out as a guiding and qualifying tool for learning and reflective practice, and the refinement of implemented activities.