The structure of Oxford and Cambridge medical degrees focuses on biomedical science in the first three years with minimal exposure to patients and clinical skills. The Oxbridge Clinical Skills Course for Preclinical Students (OPS) primarily aims to demonstrate the relevance of preclinical science as well as attain the value of this integration in such a traditional teaching framework. Previous work has shown that case-based teaching effectively achieves this aim, whereas practical sessions such as suturing are more enjoyable but incorporate preclinical science to a lesser extent.

This study aimed to investigate whether a more interactive and hands-on teaching method in the form of simulated emergency scenarios with manikins and dummy medical equipment could be as effective as previously tested theoretical methods. 60 first and second year students from Oxford and Cambridge universities completed 5 sessions, each one hour in duration: 

1. Surgical skills
   
2. Phlebotomy
   
3. Cranial nerve examination
   
4. Differential diagnosis
   
5. The new station ‘emergency scenarios’
   

Data was collected using pre- and post-course questionnaires. The students were asked to rate their expectations before the course and then following the course, they scored each station on its ability to demonstrate the relevance of preclinical science. Statistical analysis was performed using paired, two tailed, Student's t-tests with the significance level set at P<0.05. 

Prior to the course, students anticipated that theoretical teaching (formulating a differential diagnosis) would better demonstrate the clinical relevance of their preclinical science compared to practical teaching (simulated emergency scenarios) (n=60, p<0.01).  

After the course, there was a significant increase in the perceived usefulness of both differential diagnosis and emergency scenarios. In addition, there was no significant difference between these theoretical and practical teaching methods, with them rated equivalent in showing the relevance of preclinical science to clinical medicine (n=60, p>0.05).

Despite minimal clinical teaching, students were able to use their basic physiological and anatomical sciences to deal with simulated emergency clinical scenarios in ‘real time’.  This hands-on interactive teaching method was just as effective in highlighting the application of preclinical science to clinical medicine as the more theoretical method of working towards a differential diagnosis.  

Further work is required to determine whether students' understanding of biomedical science is enhanced by being able to use it in a practical setting.

With 3 years of intense biomedical science many students are left wondering why it is important and how it will fit in with clinical studies. Earlier introduction of practical teaching methods could be used to effectively demonstrate the relevance of basic sciences and sustain students’ enthusiasm.

Oxford Medical School, particularly: Dr Elize Richards, Khadar Mohammed, Dr Peggy Frith and Dr Tim Lancaster. The previous OPS organisers: Robert Watson and Maria Tsakok.

All our kind sponsors: Medical Defence Union, Wesleyan Medical Sickness, The Royal College of Physicians, The Royal College of Anaesthetists, The Royal College of Surgeons.