Physical Examination Teaching Research Articles

Randomized Controlled Trial of Physical Examination Teaching to First-Year Medical Students in the Emergency Department

Study Objectives: Utilizing a randomized controlled design, the objective of our study was to determine whether early clinical teaching in the emergency department (ED) setting, in this case specifically the teaching of physical examination skills, resulted in improved student learning as measured by their performance on an objective structured clinical exam (OSCE).

Effect of a physical examination teaching program on the behavior of medical residents.

The reliance on physical examination as a diagnostic aid is in decline. To determine whether an educational program can increase the use of physical examination by medical residents. A series of educational workshops were provided to 47 second- and third-year medical residents at a large academic teaching hospital. Interns and students reported the frequency and depth of clinical examination performance on morning rounds by their residents before and up to six months after the workshops. Behavior before and after the workshops was compared using a mixed model. A total of 374 reports were returned (77% response). After adjusting for the type of service and observer, there was a statistically significant 23% increase (P=.02) in the performance of physical examination among residents who attended the course. Residents significantly increased the fraction of patients they examined on rounds (absolute increase 11%, P=.002) but did not increase the depth of their examination. The change was greatest on general medical teams, among whom the performance of physical examination had been least frequent. Teaching and feedback events on medicine teams by residents to their interns (2.8 and 1.1 events per 2 weeks, respectively) and medical students (5.9 and 2.8 events per 2 weeks, respectively) remained infrequent. A skills improvement program can significantly increase the frequency of physical examination, but teaching and feedback events remain sporadic and infrequent.

Pelvic examination instruction and the doctor-patient relationship.

Nonphysician women instructors from a women's health center taught the pelvic examination to second-year Harvard Medical School medical students. They demonstrated the procedure and acted as subjects for the students' examinations. In addition to teaching standard techniques, the instructors showed how the patient could be offered explanation of the procedure and information about her health during the performance of the examination. The exercises are described in terms of their implications for teaching the doctor-patient relationship during physical examination instruction. The following aspects are discussed: the use of nonphysicians as "practical instructors," improving attitudes toward women and promoting patient autonomy, and redefining aspects of the student-patient relationship in clinical training.

Twelve tips for excellent physical examination teaching.

Twelve tips for excellent physical examination teaching.

The Teaching of Physical Examination in the Preclinical Years

The Teaching of Physical Examination in the Preclinical Years