PRECLINICAL SKILL DEVELOPMENT IN MEDICAL TRAINING: A COMPREHENSIVE SYSTEMATIC REVIEW OF INFLUENCING FACTORS

Background: Preclinical skills development is a foundational element in medical education. However, inadequate preparation during this phase often leads to difficulties during transition, a lack of confidence, and suboptimal clinical practice outcomes. The factors influencing preclinical skill development have not been thoroughly and systematically assessed. Methods: A systematic review adhering to PRISMA and PRISMA-S guidelines was conducted, with a comprehensive search across nine major databases (PubMed/MEDLINE, CINAHL, PsycINFO, EMBASE, Scopus, Web of Science, ERIC, Cochrane Library, Springer Link) for studies published in English between January 2000 and July 2025. Two independent researchers performed screening and quality assessment using the RoB2, ROBINS-I, QuADS, and COREQ tools. Of 4,764 articles identified, 94 full-text articles were reviewed, and 22 high-quality studies were included in the final analysis. Results: The study identified 34 influencing factors, categorized into four primary groups: (1) Educational Methods and Tools (13 factors): clinical simulation, problem-based learning (PBL), OSCE, VR/AR technology, artificial intelligence; (2) Psychosocial Factors (11 factors): communication skills, intrinsic motivation, self-confidence, peer-assisted learning; (3) Environmental and Contextual Factors (7 factors): faculty support, infrastructure, student-to-faculty ratio; (4) Individual Factors (3 factors): foundational knowledge, year of study, prior learning experience. Clinical simulation, PBL, and OSCE demonstrated the strongest evidence of effectiveness, while modern technologies and multi-source feedback play a crucial supplementary role. Conclusions: The development of preclinical skills is shaped by a range of factors, including educational methodologies, psychosocial aspects, environmental conditions, and individual characteristics. This study offers a solid scientific basis for the advancement of modern medical education policies, while emphasizing the need for further research into the long-term effects and cross-cultural applications to optimize the quality of preclinical training.