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J R Soc Med. 2001 December; 94(12): 655.
PMCID: PMC1282315

Students sitting finals: ready to be house officers?

Mr Goodfellow and Dr Claydon suggested that the competence of medical students in practical procedures could be improved by introduction of skills laboratories and logbooks. I fully agree about skills laboratories and there is sufficient evidence to support them1,2. However, I disagree with the use of logbooks. As acknowledged in the paper, most logbooks simply testify that a procedure was performed and do not certify competence, although this deficiency could be overcome by asking the doctor to grade competence as good, average or below average. I would also suggest that logbooks cause additional stress to many students and become a major preoccupation. Even if doctors' evaluations were conscientiously done, the logbooks might offer a temptation to student fraud3,4. After training in a skills laboratory, students should be assessed on models with an objective structured clinical examination (OSCE) before practising on real patients.


1. Bradley P, Bligh J. One year's experience with a clinical skills resource centre. Med Edu 1999;33: 114-20 [PubMed]
2. Fox R, Dacre J, Mclure C. The impact of formal instruction in clinical examinations skills on medical student performance—the example of peripheral nervous system. Med Edu 2001;35: 371-3 [PubMed]
3. Rennie SC, Crosby JR. Are tomorrow's doctors honest? Questionnaire study exploring medical students' attitudes and reported behaviour on academic misconduct. BMJ 2001;322: 274-5 [PMC free article] [PubMed]
4. Paton J. Cheating at medical school. Main impact of cheating is on clinical work. BMJ 2001;322: 298 [PMC free article] [PubMed]

Articles from Journal of the Royal Society of Medicine are provided here courtesy of Royal Society of Medicine Press