Methods All final year medical students for last 2 years in Rwanda attended a full 5 day ETAT+ course. It is designed for hospital staff, but full course was chosen as the following year the students will be working in district hospitals, usually as the most senior doctors. They took a knowledge test (multiple choice questions) at the start of the course. After the course, the same knowledge test was taken and two clinical skills scenarios were assessed, using standardised criteria. Candidates had to retake the scenario if they did not pass all the criteria and failed if they did not pass all the criteria on retesting. At the end of the academic year, 3–9 months later, their knowledge and clinical skills were reassessed with the same knowledge and clinical skills tests.
Results Between Nov 2011-May 2012, 91 medical students attended one of 4 courses. In August 2012, 81 students were re-evaluated.
The knowledge test results (figure 1): pre-course, median score was 47% (inter-quartile range 35.65); after the course 71% (inter-quartile range 63, 75). There was a statistically significant improvement in performance (Wilcoxon matched-pairs signed rank test p < 0.0001). On re-evaluation, median MCQ results were 67%, (inter-quartile range 52, 75), not significantly different from post-course performance.
Clinical skills assessments (Table 1) showed that 95% passed immediately after the course, with 72% passing both at their first attempt. On re-evaluation, 74% passed, 47% at their first attempt (Chi-squared p < 0.01).
Conclusion On evaluation immediately after the full ETAT+ course, there was a marked improvement in knowledge and most passed the clinical skills. The medical students coped well with the full course. On re-evaluation 3 – 9 months later they retained their knowledge but clinical skills declined, showing refresher courses are required to maintain clinical skills.