PREVALENCE OF PEDIATRIC CLINICAL SKILL CONFIDENCE AMONG MBBS UNDERGRADUATES DURING HOSPITAL-BASED WARD TRAINING: A CROSS-SECTIONAL STUDY

Abdullah  Ayoob; Ayesha Asghar; Zubair Ahmad

Authors

Abdullah Ayoob LUMHS, Pakistan. Author
Ayesha Asghar Bahria University College of Medicine, Pakistan. Author
Zubair Ahmad Services Hospital Jail Road Lahore, Pakistan. Author https://orcid.org/0009-0009-2295-2495

Keywords:

Clinical Competence, Confidence, Cross-Sectional Studies, Medical Education, Pediatrics, , Self-Efficacy, Students, Medical, Teaching Rounds

Abstract

Background: Clinical skill confidence among medical undergraduates plays a vital role in shaping competence, professional development, and quality of patient care. Pediatric training presents unique challenges, as students must interact with both children and their caregivers while mastering specialized clinical techniques. Limited exposure, inadequate supervision, and restricted hands-on opportunities may result in variable levels of confidence during pediatric ward training.

Objective: To evaluate the level of self-reported confidence in pediatric clinical skills among MBBS undergraduates during ward rotations.

Methods: A cross-sectional study was conducted over five months among MBBS students in Lahore. Using stratified sampling, 216 undergraduates were enrolled, comprising both fourth-year and final-year students. Data were collected through a structured, validated self-administered questionnaire using a 5-point Likert scale to assess confidence across domains including history taking, growth assessment, newborn examination, respiratory and cardiovascular assessment, and procedural skills. Descriptive statistics summarized the findings, while independent t-tests and Pearson’s correlation were applied for inferential analysis. Ethical approval and informed consent were obtained prior to the study.

Results: The mean age of participants was 22.6 ± 1.3 years, with 51.4% males and 48.6% females. Overall mean confidence score was 3.2 ± 0.6, indicating moderate confidence. Distribution revealed 28.2% with low confidence, 45.4% with moderate confidence, and 26.4% with high confidence. Final-year students reported significantly higher scores compared to fourth-year students (3.4 ± 0.5 vs. 3.0 ± 0.6, p < 0.001). Domain-specific analysis showed highest confidence in history taking (3.6 ± 0.7) and lowest in procedural skills (2.7 ± 0.9). A positive correlation was observed between number of supervised encounters and overall confidence (r = 0.38, p < 0.001).

Conclusion: The study highlighted that undergraduate students predominantly reported moderate confidence in pediatric clinical skills, with significant variability across domains. Increased clinical exposure and structured supervision were strongly associated with higher confidence, underscoring the need to strengthen ward-based pediatric training.

Author Biographies

Abdullah Ayoob, LUMHS, Pakistan.

4th year MBBS, Medicine and Basic Health Sciences, LUMHS, Pakistan.
Ayesha Asghar, Bahria University College of Medicine, Pakistan.

1st year MBBS Student at Bahria University College of Medicine, Pakistan.
Zubair Ahmad, Services Hospital Jail Road Lahore, Pakistan.

Senior Registrar Pediatrics Department, Services Hospital Jail Road Lahore, Pakistan.

References

1. Maurits EE, de Veer AJ, van der Hoek LS, Francke ALJBHSR. Factors associated with the self-perceived ability of nursing staff to remain working until retirement: a questionnaire survey. 2015;15(1):356.

2. Liu F, Niu P, Yu S, Wei L, He X, Ye J, et al. Investigating students’ perceptions of the medical education environment and learning autonomy in blended learning in pediatrics: a cross-sectional study. 2024;24(1):1464.

3. Nhung LH, Hang PT, Thuy NT, Hoc PV, Lan NP, Han PD, et al. Validation and reliability of the self-efficacy scale to assess the professional competence of pediatricians participating in continuing medical training program according to the ECHO model. 2023:2023.08. 03.23293598.

4. Williams B, Beovich B, Ross L, Wright C, Ilic DJJoIC. Self-efficacy perceptions of interprofessional education and practice in undergraduate healthcare students. 2017;31(3):335-41.

5. Idala LG. SEM approach in understanding confidence, competence, and effectiveness in clinical teaching among nurse preceptors.

6. Zia Z, Salehi A, Amini M, Vardanjani HM, Tavabe MSJJoE, Promotion H. Relationship between research self-efficacy and evidence-based practice in the medical students. 2022;11(1):221.

7. Mazurkiewicz R, Korenstein D, Fallar R, Ripp JJP, health, medicine. The prevalence and correlations of medical student burnout in the pre-clinical years: a cross-sectional study. 2012;17(2):188-95.

8. Yuen B, Asmar A, Kibble JJMSE. Trainee Identification of the Self-efficacy Domains Needed to Succeed in Undergraduate and Graduate Medical Education. 2025:1-9.

9. Perugu S, Sreedaran P, Chari U, Sethuraman B, Salazar LJJIJoPM. An evaluation of the first clinical posting in psychiatry of the competency-based medical education (CBME) curriculum for undergraduate medical students in India. 2024;46(5):452-8.

10. Thapa S, Nielsen JB, Aldahmash AM, Qadri FR, Leppin AJJme. Willingness to use digital health tools in patient care among health care professionals and students at a University Hospital in Saudi Arabia: quantitative cross-sectional survey. 2021;7(1):e18590.

11. Gao H, Liu X, Jiang Z, Huang S, Pan X, Long J, et al. Knowledge, attitudes, practices, and self-efficacy of the Chinese public regarding cardiopulmonary resuscitation: an online cross-sectional survey. 2024;12:1341851.

12. Papanagnou D, Ankam N, Ebbott D, Ziring DJMEO. Towards a medical school curriculum for uncertainty in clinical practice. 2021;26(1):1972762.

13. Momeni M, Asadi M, Shadin H, Noorian S, Senmar MJBME. Self-efficacy of clinical performance in nursing students and its relationship with the motivation of field choice and clinical education status. 2025;25(1):767.

14. Kallerhult Hermansson S, Norström F, Hilli Y, Rennemo Vaag J, Bölenius KJBHSR. Job satisfaction, professional competence, and self-efficacy: a multicenter cross-sectional study among registered nurses in Sweden and Norway. 2024;24(1):734.

15. Ylitörmänen T, Turunen H, Kvist TJJonm. Job satisfaction among registered nurses in two Scandinavian acute care hospitals. 2018;26(7):888-97.

16. Sommer D, Wilhelm S, Wahl F, editors. Nurses’ workplace perceptions in southern Germany—job satisfaction and self-intended retention towards nursing. Healthcare; 2024: MDPI.

17. Högstedt D, Eriksson E, Jansson I, Engström MJIjons. Self-rated professional competence and well-being at work after obtaining a Swedish nursing license: A longitudinal mixed-methods study of internationally and domestically educated nurses. 2024;157:104812.

18. Gardulf A, Orton ML, Eriksson LE, Undén M, Arnetz B, Kajermo KN, et al. Factors of importance for work satisfaction among nurses in a university hospital in Sweden. 2008;22(2):151-60.

19. Andresen IH, Hansen T, Grov EKJNjonr. Norwegian nurses’ quality of life, job satisfaction, as well as intention to change jobs. 2017;37(2):90-9.

20. Kuokkanen L, Leino-Kilpi H, Numminen O, Isoaho H, Flinkman M, Meretoja RJBn. Newly graduated nurses’ empowerment regarding professional competence and other work-related factors. 2016;15(1):22.

21. Lindqvist R, Smeds Alenius L, Runesdotter S, Ensio A, Jylhä V, Kinnunen J, et al. Organization of nursing care in three Nordic countries: relationships between nurses’ workload, level of involvement in direct patient care, job satisfaction, and intention to leave. 2014;13(1):27.

22. Allvin R, Bisholt B, Blomberg K, Bååth C, Wangensteen SJBn. Self-assessed competence and need for further training among registered nurses in somatic hospital wards in Sweden: a cross-sectional survey. 2020;19(1):74.