Self-confidence and clinical skills: the case of students who study medicine in English in a non-English speaking setting

An increasing number of international students has been enrolling in medical studies in the English language offered by the countries of Eastern Europe. Development of practical skills is likely more challenging when students learn in the English language, while their patients are non-English speaking persons.

To evaluate self-perception of practical skills of medical students in the English language program.

From December 2016 to December 2017, a total of 52 students from the Studies in English program of two universities in Serbia were included in the study. Data were obtained by a previously validated questionnaire.

Participants were most confident when measuring blood pressure, checking the arterial pulse, and taking history. Students were the least confident when placing urinary catheters, performing rectal examinations, and suturing wounds. Male students reported higher confidence in “Major interventions” compared to females (p = 0.004), and no difference between male and female students was found in the total skill score of “knowledge of Serbian language” (p = 0.339). Adjusted analysis showed that a higher grade point average remains associated with a more confident perception of one’s practical skills (B 26.48, 95% confidence interval 8.98–43.98). Rasch analysis showed that because the scores were distributed around the mean value between “not confident at all” and “quite confident,” the majority of students had similar perceptions of their skills.

Active supervision by teaching staff is also recommended in an attempt to rectify the lack of confidence at performing a range of clinical procedures which is present among international students.