Background: The restrictions imposed by the COVID-19 pandemic led to the rapid development and implementation of digital methods for teaching clinical skills in medical education. This systematic review presents the benefits, challenges, and effectiveness of this transition.
Methods: A systematic search was conducted in six electronic databases (SCOPUS, Medline, CINAHL, PsycINFO, ERIC, and Informit) on October 1, 2023, and updated on April 1, 2024, to identify peer-reviewed articles published from 2019 onward. The inclusion criteria required the use of any type of digital tool (online or otherwise) for teaching clinical skills to medical students (undergraduate or postgraduate) and publication in English. The primary synthesized outcome was the reported effectiveness of these digital tools in developing clinical skills. The risk of bias in the included studies was assessed using the Quality Assessment With Diverse Studies (QuADS) tool.
Results: Twenty-seven studies, with a total of 3,895 participants, were eligible for inclusion in this review. Quality scores based on QuADS ranged from 22 to 35, indicating moderate quality, and thirteen of the studies were randomized controlled trials. Overall, digital teaching of clinical skills showed improved or comparable results to traditional face-to-face teaching. There was a beneficial effect of digital learning tools on assessment outcomes, with one meta-analysis showing a mean difference increase of 1.93 (95% CI: 1.22 to 2.64), although with high statistical heterogeneity (I² = 97%, P < 0.001). Digital teaching of clinical skills also resulted in higher student satisfaction in many cases and, according to one study, proved to be cost-effective.
Conclusion: Teaching clinical skills using digital tools is an important alternative to the traditional in-person format, which is resource-intensive and challenging to implement during a pandemic. This review demonstrates the potential effectiveness of digital tools in enhancing educational outcomes, student satisfaction, and possibly reducing costs. However, integrating both traditional and innovative digital teaching methods appears to provide the most comprehensive learning experience. Future research could focus on longitudinal studies to evaluate the long-term impact and effectiveness of various digital and hybrid learning modalities on clinical skills acquisition and professional competencies.
McGee et al. (2024). Digital learning of clinical skills and its impact on medical students’ academic performance: a systematic review. BMC Medical Education, 24:1477. https://doi.org/10.1186/s12909-024-06471-2
García Dieguez M. Comment on the Clinical Skills in the Digital Age: A Systematic Review on Academic Impact. [Internet]. Pan American Health Organization. Bibliographic Repository. Cited on 07/10/2025. Available at: https://campus.paho.org/en/repo/clinical-skills-digital-age-systematic-review-academic-impact
García Dieguez M.
CEEProS Universidad Nacional del Sur
This article is recommended for educators involved in training health professionals who are evaluating the impact of digital tools on clinical skills teaching, particularly regarding students' academic performance. It summarizes the current post-COVID-19 evidence on the use of digital resources (videos, online modules, simulations, simulated electronic health records, etc.) for acquiring clinical competencies, especially in areas such as medical history taking, physical examination, communication, and clinical reasoning. It provides systematic, comparative, and updated data to support curriculum decisions, particularly for designing hybrid models.
The study systematically reviews 27 studies (n=3895 medical students) with various methodologies (RCTs, observational studies, mixed methods), analyzing the effect of digital interventions on the teaching of clinical skills (history taking, physical examination, communication, clinical reasoning, procedural skills). Overall, the use of digital tools showed:
- Academic outcomes in some studies comparable to or better than face-to-face learning, though with high statistical heterogeneity.
- Improved student satisfaction.
- In some cases, increased knowledge retention and self-confidence among students.
- Combined face-to-face and digital learning seems to offer the best results.
Main limitations include:
- High statistical and methodological heterogeneity among studies.
- Wide variety of digital interventions, making uniform conclusions difficult.
- Limited assessment of impact on complex manual skills.
- Lack of longitudinal evidence on sustained long-term effects.
While the article provides a robust and updated overview, gaps remain regarding the global impact on comprehensive clinical competence.
The main practical utility of this study is to encourage the design of hybrid courses combining digital and face-to-face modalities, as it:
- Provides updated evidence supporting the use of digital technologies for learning specific clinical skills.
- Offers concrete examples of applicable tools (videos, modules, simulated electronic records, videoconferences, etc.).
- Provides arguments to integrate digital resources into clinical competency programs and justify institutional investments in educational technologies.
- Serves as a resource for discussing post-pandemic curriculum redesign with teaching teams.
- Warns about the limitations of certain digital tools in developing high-level technical skills (e.g., CPR, surgical skills).
- Guides future educational research, particularly on hybrid models and the longitudinal evaluation of their effects.
As with any review, it provides primary references for further exploration of each specific intervention. However, the heterogeneity of included studies suggests that results should be interpreted cautiously and contextualized to each institutional reality.