Pre-service medical education from theory to practical skills teaching contributes to health care quality improvement

For decades the medical education in Georgia was focused heavily on knowledge, while the clinical skills were mostly ignored. The lack of clinical practice for students needs to be supplemented by teaching clinical skills using modern simulation methods and equipment. Since 2009, JSI SUSTAIN project, funded by USAID, has been providing technical assistance to medical education institutions countrywide through trainings of medical faculty on curriculum development, student evaluation techniques, and advanced methods of teaching. In 2011, project supported Tbilisi State Medical University in setting-up and operating a clinical skills teaching center (CSTC) and introducing the objective structured clinical examination (OSCE) methodology. Leading medical faculty members were trained by international experts on case-based teaching and OSCE methods. International observation tours were organized to study the operation of the clinical skills center and the OSCE process, and to share experience with foreign colleagues. The TSMU CSTC was reequipped and restructured to make it more student-friendly and functional. According to the new curriculum, clinical skills practice has become mandatory requiring every student to spend a specific amount of time each semester in the CSTC to acquire and practice clinical skills. In 2012, TSMU CSTC hosted its first OSCE for nurses. The TSMU prepared seven testing stations (standardized simulated clinical situations). Of 1043 nurses 72% passed the threshold score of 54%. Over the next five years, TSMU is planning to fully integrate the OSCE into the medical curriculum, meaning that students will be evaluated by this method during every year of their medical education.