An exploratory study on the use of the self-directed learning, self-video recording, peer-to-peer review, and Direct feedback model to enhance clinical skills among medical students in Southern Thailand

Abstract

BACKGROUND: Regional teaching hospitals in Southern Thailand must train large student cohorts despite limited faculty and heavy clinical workloads. We explored whether a composite Self-directed learning, Self-video recording, Peer-to-peer review, and Direct feedback (SSPD) model can strengthen core clinical skills under these constraints. MATERIALS AND METHODS: A quasi-experimental one-group pretest–post-test study was conducted among n = 49 clinical-year medical students from Surat Thani and Maharaj Nakhon Si Thammarat Hospitals (March to September 2024). Students completed a four-station Objective Structured Clinical Examination (OSCE) covering history taking, physical examination, procedural skills, and patient counseling both before and after a four-component SSPD intervention. The primary outcome was the change in OSCE scores; secondary outcomes were learner satisfaction and frequency of video use. Mean differences were analyzed with paired-sample t-tests (α = 0.05), and effect sizes were expressed as Cohen’s d with 95% confidence intervals (CI). RESULTS: Significant gains were observed in history taking (Δ = 9.84 ± 15.39; 95% CI: 5.42–14.26; d = 0.64; P < 0.001), physical examination (Δ = 16.37 ± 19.08; 95% CI: 10.89–21.85; d = 0.86; P < 0.001), and patient counseling (Δ = 38.20 ± 18.71; 95% CI: 32.83–43.57; d = 2.04; P < 0.001). Procedural skills showed no meaningful change (Δ = 0.06 ± 17.51; 95% CI: −4.97–5.09; d ≈ 0.00; P = 0.981). Learners reported high satisfaction with self-directed learning and self-video recording components; 51% reviewed their videos. CONCLUSIONS: Despite the absence of a control group, medium-to-large effect sizes in three of four skill domains suggest the SSPD model is a feasible, scalable option for resource-limited clinical settings. Controlled trials should confirm these findings and determine long-term outcomes.