Enhancing medical students’ self-efficacy toward national competency standards: a student-led training model in a lower-middle-income country

Following a national reform, Egyptian medical schools adopted the National Academic Reference Standards (NARS) in a transition toward competency-based education. However, preparing graduates to meet these standards remains challenging amid rapidly increasing student numbers and limited resources. This study evaluated the impact of the student-led Shouman Summer Training 2023/2024 (SST24) on trainees’ self-efficacy toward the NARS competencies. SST24 took place in August 2024 at Mansoura University Hospital’s departments across two 14-day waves. The program enrolled 652 trainees across 31 clinical departments, and combined hands-on bedside teaching, supervised procedures, and two supplementary workshops aligned with the NARS competencies. A pre–post observational design was used to assess changes in three outcomes: 1) self-efficacy toward NARS competencies measured with a 5-point self-report questionnaire; 2) clinical empathy, using the Jefferson Scale of Empathy (JSE-S); and 3) clinical knowledge, assessed with department-specific quizzes. Pre-post changes were analyzed using paired t-tests, mean differences (MD), and Cohen’s d. Of 652 trainees, 535 met inclusion criteria for the final analysis (82%). The program led to significant overall gains in self-efficacy toward NARS competencies (p < .001), but the outcomes varied depending on the training environment. Trainees in ‘People-Oriented’ departments, which emphasized patient interaction, reported higher gains in identifying health risks and adopting infection control measures compared to their peers in technical settings (MD = 0.85; d = 0.93 vs. MD = 0.49; d = 0.38). Conversely, trainees in ‘Technology- and Procedure-Oriented’ departments reported greater self-efficacy gains in adopting patient safety measures (MD = 1.64 vs. 1.31) and adhering to professional standards (MD = 0.72 vs. 0.58). However, the intensive focus on technical skills in these departments was associated with a modest but significant decline in empathy (mean JSE-S score change = -2.34). Clinical knowledge scores also improved significantly, with mean correct answers increasing by 15.8 and 14.1 percentage points in technology- and people-oriented departments, respectively (p < .001). SST24 enhanced trainees’ self-efficacy towards NARS competencies, as well as department-specific knowledge, demonstrating a scalable, student-led model for resource-limited settings.