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

  • Tatjana Gazibara
  • Megan Wiltshire-Fletcher
  • Gorica Maric
  • Dusko Kozic
  • Darija Kisic-Tepavcevic
  • Tatjana Pekmezovic
Original Article



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.


International Medical students Self-perception Skills 



We are grateful to all the students who participated and took an interest in this study.


The study was supported by the Ministry of Education, Science and Technological Development of the Republic of Serbia (grant no. 175087).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Research involving human participants and/or animals

All procedures involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Supplementary material

11845_2018_1947_MOESM1_ESM.docx (111 kb)
ESM 1 (DOCX 111 kb)


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Copyright information

© Royal Academy of Medicine in Ireland 2018

Authors and Affiliations

  1. 1.Institute of Epidemiology, Faculty of MedicineUniversity of BelgradeBelgradeSerbia
  2. 2.Department of Radiology, Faculty of MedicineUniversity of Novi SadNovi SadSerbia

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