Examination Skills Research Articles

Core and cluster or head to toe?: a comparison of two types of curricula for teaching physical examination skills to preclinical medical students

BackgroundDespite the central importance of physical examination (PE) skills to patient evaluation, early trainees struggle with its correct application and interpretation. This struggle may reflect the instructional strategies of PE courses which have largely ignored the clinical reasoning necessary to accurately apply these skills. The “core + cluster” (C + C) is a recent approach to teaching PE to clerkship-level medical students that combines a basic ‘core’ exam with ‘cluster’ based on the student’s hypothesis about their patient’s clinical presentation. Our institution developed a novel C + C curriculum to teach PE to preclinical students. We aimed to assess the impact of this new curriculum on students’ clinical skills and course evaluations in comparison to the traditional “head-to-toe” approach we’d used previously.MethodsThis was a retrospective study comparing two consecutive medical school cohorts exposed to the new (C + C) and prior (HTT) curricula respectively. We studied two complete cohorts of first-year medical students at our institution who matriculated in 2014 and 2015. The 2014 cohort received PE training via an HTT approach. The 2015 cohort received PE training via a C + C approach. Outcomes included performance scores on a statewide clinical performance exam (CPX) and student course evaluations.ResultsWe found no statistically significant difference in mean CPX scores between the two cohorts. However, student course ratings were significantly higher in the C + C cohort and students rated the C + C format as highly useful in clinical encounters.ConclusionsThe C + C curriculum appears to be as effective a method of teaching PE to preclinical students as the HTT approach and is better received by students. We believe that this approach more appropriately reflects the way PE is used in clinical encounters and may help students with diagnostic hypothesis generation.

Penatalaksanaan Fisioterapi pada Kasus Development Delay: Case Report

Growth and development have similarities in change. And these changes involve all physical members, motor skills and language development. If there are abnormalities in the child's growth and development process, then the child will experience delays in growth and development which is usually called Developmental Delay. This study aims to determine the effect of play therapy on the growth and development of children with developmental delay conditions. This research uses the case study method. After carrying out therapy 8 times, the results showed that play therapy had an effect on improving gross motor skills and improving balance in children with developmental delay. Examination of children's motor skills using the DDST (Denver Development Screening Test) revealed an increase in several stages of ability development in gross motor aspects. Examination of the child's balance using the PBS (Pediatric Balance Scale) showed an increase in balance in several categories, such as the child being able to stand independently and turning 360°.

The Effect of UMP Phantom Antenatal Care (ANC) Innovation on Leopold Examination Knowledge and Skills in Students at SMK Muhammadiyah 3 Purwokerto

Background: Knowledge and skills are competencies that Nursing Assistant Vocational High School students must possess to create competent graduates. One of those knowledge and skills is the Antenatal Care (ANC) examination. The inadequate facilities and infrastructure at SMK can disrupt the learning process. The application of learning media can influence the learning process. The limited number of teaching aids can be an inhibiting factor in practical learning. The phantom innovation of antenatal care is a visual aid that resembles the body shape of pregnant women used for Leopold examinations. Method: The research method used Quasi Experiment using a posttest-only control group design approach. The population in this study were students of nursing assistants in XI and XII Grades at SMK Muhammadiyah 3 Purwokerto. The sample in this study amounted to 52 people. The sampling technique used was the total sampling technique. The data analysis used was univariate and bivariate analysis with the Mann-Whitney test. Results: The results showed that there is an influence of the Phantom ANC UMP innovation on the respondents Leopold examination knowledge and skills obtained from statistical test result the asymp sig value. (2-tailed) knowledge 0.00 and asymp value sig. (2-tailed) skill 0.01 which means the p value <0.05. Conclusion: The student's knowledge and skills regarding Leopold's examination were higher in the group using Phantom ANC UMP media than in the group using powerpoint media.

Teaching Ultrasonographic Basic Examination Skills (TUBES): Assessment of an Ultrasound Skill Simulator in Teaching Ultrasound-Guided Paracentesis, a Prospective Observational Study.

Ultrasound guidance during centesis is recommended to reduce the risk of serious complications, improve success rate, and to choose appropriate sampling locations and equipment. The aim of this study was to develop an accessible and reusable ultrasound skill simulator for ultrasound guided centesis (USGC). Fifty second year veterinary students reviewed an instructional video prior to performing two USGC skill tests on the simulator, separated by a period of practice. Following practice there was a significant improvement in score (p < .0001), and average score and time improved by 8.6% and 163.3 seconds respectively. The proportion of successful aspirates improved by 9%, from 66% to 75%. Most post-session survey feedback was positive, and none was negative. Thirty-eight of 49 participants (78%) indicated they would prefer learning this skill with the simulator or in combination with individual practice and/or observation. Ninety-eight percent (49/50) strongly agreed that "this training simulator should be incorporated into the veterinary curriculum," and 94% (47/50) strongly agreed with "I would use this training simulator again to practice basic ultrasound skills." Eighty-four percent (42/50) strongly agreed their skills and knowledge improved using the simulator and 82% (41/50) strongly agreed they gained confidence with ultrasound using the simulator. The remainder of the responses for these four questions was agreement, and no student disagreed with any of the statements. The authors conclude this is an effective and well-received simulator for teaching ex vivo USGC and recommend incorporation into the veterinary curriculum for basic ultrasound skill training.

Examination of Inquiry Learning Skills toward Geometry in terms of Various Variables

Purpose: Questioning, discovering, generalizing, verifying, and disproving are fundamental aspects of geometry teaching. As seen, the inquiry is at the geometry’s core. According to this, inquiry learning toward geometry is a student-centered learning process that allows the student to construct geometric information and to create permanent learning by actively using inquiring skills such as hypothesizing, proving, and disproving in the geometry learning process. To see this process in detail, the purpose of this study is to examine middle-schoolers’ levels of inquiry learning skills toward geometry, as well as their relationship to various variables. Design/Methodology/Approach: In the survey model, 312 middle school students participated in the study. Data were collected using the Inquiry Learning Skills Scale for Geometry and Demographic Information Form. Findings: It has been determined that middle-schoolers have a high level of inquiry learning skills toward geometry. As a result, inquiry learning skills toward geometry were found to significantly differ by gender, father’s educational status, year-end achievement score, asking questions, using materials in the lesson, and associating geometry with daily life. However, there was no significant difference between these skills and the grade level and mother’s education status. Highlights: By using concrete abstract materials or models related to daily life in lessons, teachers can attract students’ interest, arouse curiosity in students, and encourage students to use and develop their inquiry learning skills. In addition to educational activities at school, parents can contribute to the development of certain skills such as observation and questioning by creating opportunities for their children to participate in scientific activities at home or in their social environment and exposing them to different stimuli.

An Examination of Preschool Children's Play Skills and Independent Learning Behaviors in Türkiye

Preschool education enables children to develop play skills and independent learning behaviors. This study aims to understand the association between preschool children's play skills and independent learning behaviors. The study was a relational survey model, with 380 children within the 5-year age group attending preschool and kindergarten school in Türkiye. The children were observed for one month. Teachers assessed their play skills and independent learning behaviors using “the Game Skills Scale (GSS)” and “Children's Independent Learning Development Checklist (CHILD 3-5)”. The descriptive result of the study, the children's play skills, and independent learning behaviors were found to be high; there was a significant difference according to gender in favor of girls; and the mean score changed according to the school type (the mean of the children attending kindergarten were higher, but the difference was not significant). A positive and strong relationship was found between children's independent learning behaviors and play skills, indicating that children's play skills had a significant effect on their independent learning behaviors.

A qualitative study exploring the challenges and enablers of pharmacists with a recent background in community pharmacy transitioning into primary care.

Pharmacists are an increasing part of the primary care health care team in Scotland. Recruitment to this expanding sector has largely come from community pharmacy. However, it is unknown if these pharmacists have specific needs to perform their role within the primary care team. To explore the perceived challenges and enablers of community pharmacists transitioning into primary care pharmacist roles. Eight pharmacists (5 female, 3 male, median age 32) across Scotland's largest regional health board who previously practised in community pharmacy participated in a recorded, semi-structured interview via Microsoft Teams® to explore their challenges and enablers of transition into primary care. Recordings were transcribed, verified, and thematic analysis then undertaken. Five themes were identified: challenging transition, transferable skills, transferable training from community pharmacy, training needs for primary care role, and benefits of structured learning. Participants reported lack of opportunity to apply their clinical knowledge and for professional development in community pharmacy. Pharmacists in our study reported a range of challenges (such as examination skills, improved clinical and therapeutics knowledge) required to practice in primary care, while their regular patient contact and knowledge of community pharmacy workings enabled their transition. Previous sectors of practice should be taken into consideration when inducting pharmacists into a new role and background specific inductions may need to be implemented to support these pharmacists work autonomously at an advanced level.

Exploration and Application of Three-stage Strengthening Mode based on Massive Open Online Course to Improve Students’ Competence in Electrocardiogram Interpretation Skills

Electrocardiogram (ECG) is a widely common diagnostic test in clinical practice. However, research has shown that residents and medical students cannot analyze ECG skillfully. In this study, we explore a three-stage strengthening mode based on massive open online course (MOOC) to improve students’ competence in ECG interpretation skills. We carry out the first stage in a diagnostics course, in which instructors adopted online and offline blended mode for the teaching method of ECG with clinical medicine students in grade 2018 based on MOOC. We compare scores of ECG interpretation skills for 91 students in grade 2018 with 81 students in grade 2016 to evaluate the effect. The second stage concerns studying internal medicine, in which we divide students in grade 2018 into two groups with 49 students in group A and 42 students in group B. Group A strengthened their ECG interpretation skills when learning about heart diseases. The third stage pertains to rotation in the internal medicine department in the internship period. Some students in group A continued to receive intensive training. Students in group B had no reinforcement arrangement in the second and the third stage. Students in grade 2018 took graduation tests at the end of their internship. We use the scores on ECG interpretation skills in the graduation examination to evaluate the strengthening effect between group A and group B. The result of the first stage shows that scores on ECG interpretation skills in the final exam in grade 2018 were 19.32 ± 4.62 points, which is higher than those of grade 2016, whose points were 16.89 ± 5.30 (total scores in both grades were 30 points). Difference is statistically significant. Scores on the graduation examination in group A were 38.89 ± 16.81 points, and those of group B were 26.86 ± 15.43 points (total score was 60 points), with statistical difference between these two groups. The three-stage strengthening mode based on ECG MOOC is an effective method to improve students’ ECG interpretation skills. Results show that an online and offline blended teaching strategy is superior to the traditional lecture method. Repeated practice is necessary for improving ECG interpretation competence. Students in the strengthening program group had better grades in the graduation examination.

Analysis of visual-based physics questions of the senior high school entrance examination in China

The notion of scientific visual literacy has been advocated in recent science curriculum reform documents and related learning outcomes are expected from students. However, few studies have been conducted to determine how it is tested in high-stakes examinations. This study utilized the Visualization Blooming Tool to examine the level of visual cognition involved in visual-based physics questions in the Senior High School Entrance Examination (SHSEE) in China. Content analysis was adopted as the research method and 12 sets of the SHSEE physics from four Chinese metropolises (Beijing, Shanghai, Hangzhou, and Suzhou) in 2020, 2021, and 2022 were targeted. The results indicate that although all four metropolises examined the higher-order visual cognitive skills, they placed more emphasis on the levels of apply and analyze but less on evaluate and create. Moreover, the examination items required students to interpret visual representations more often than to construct them, which may be detrimental to developing students’ scientific visual literacy. It is suggested that the examination of higher-order visual cognitive skills and encoded visual representation should be strengthened in future high-stakes physics examinations. Published by the American Physical Society 2024

A complementary medicine student-led telehealth clinic: evaluating learning & teaching perceptions

ObjectivesThis study evaluates a multi-centered complementary medicine (CM) student-led telehealth clinic during the COVID-19 pandemic. Likert and qualitative responses explore student and educator learning and teaching perceptions of the implementation of a successful telehealth clinic.Results51 students and 17 educators completed the survey. Respondents agreed that support from educators (90%) and orientation (70%) assisted effective performance. Over 90% (93%) of all respondents supported telehealth in student-led clinics, whilst 87% encountered barriers such as technical and infrastructure issues. Respondents agreed that telehealth practice skills improved in case history taking (90%), treatment (90%) and building patient rapport (60%). Respondents (61%) disagreed that physical examination was effectively performed, and 100% of respondents agreed telehealth was a valuable learning experience. This study is the first to explore student and educator perceptions of telehealth in an Australian University multi-centered CM student-led clinic. To be successful in an educational environment, students and educators require digital literacy and adequate telehealth practice infrastructure. Whilst some in-person practice skills are transferable to telehealth, educators need to adapt curriculum to ensure counselling and physical examination skills are specifically taught for virtual consultations. Telehealth in clinical practice requires continued investigation and educational development.

Digital Competencies and their Impact on Public Servants' Productivity in Peru

In an increasingly digitized environment, with a heavy reliance on Information and Communication Technologies (ICT), the significance of digital competencies (DC) in the public sector is undeniably crucial. This study focuses on assessing the impact of DC on the productivity of public servants in a governmental entity in Peru during 2022. Utilizing logistic regression analysis on a sample of 134 participants, and asserting a 99% confidence level with a 3.8% margin of error, it is concluded that DC accounts for a significant proportion (24.9%) of productivity variability. The analysis identifies a deficiency in DC among older public servants, following an examination of skills in information, communication, creation, digital security, and digital empathy. While communication sk ills are prominent, creative abilities emerge as the most vulnerable aspect. This study advocates for the implementation of a training program aimed at enhancing DC, with a particular emphasis on creative skills, and adopting a tailored approach for digital natives and immigrants. The training plan should be underpinned by the proposed concept of DC within a directed acyclic diagram, illustrating the integration and interrelation of the five key digital skills - information, communication, creation, digital security, and digital empathy - thereby enhancing productivity through increased effectiveness and efficiency

Examination of basic motor skills in children and adolescents.

Aim of the study: The aim of this study was the investigation of basic motor skills in 5-14-year-old boys and girls. Materials and Methods: A total of 842 primary school children, 421 boys and 421 girls, participated in the study. 13.3% of the participants were 5-6years old, 29.5% were 7-8years old, 21.5% were 9-10years old, 16.4% were 11-12, and 19.4% were 13-14years old. The balance skills of the participants were measured with the (Körperkoordinationstest für Kinder) KTK test. Findings: When the classification of children according to KTK defining classes is examined, 40.7% are very good. When the children's KTK Backward Balancing scores were examined, a statistically significant difference was found between gender and age groups (p < 0.05). Girls between the ages of 5-6 and 7-8years had a higher score for KTK backward balance. KTK Total scores were examined according to the Body Mass Index groups, when the total scores of KTK were compared, the lowest scores were in the obese group. Conclusion: According to the study results, age is an essential factor for balance skills. As the age increased, the overall scores of the KTK increased. It was determined that girls' KTK backward balancing scores were higher than boys. According to BMI results, the balance performances of obese children were found to be lower than the other groups. This difference can be explained by the negative effect of obesity in this age group. According to these results, it may be recommended to observe and improve the balance performances of obese children.

Comparison of Peyton's Four-Step Approach With the Conventional Bedside Technique in Teaching Clinical Examination Skills to Medical Students.

Conventional bedside teaching (CBT) is an integral and classical method for imparting clinical skills to undergraduates in medical schools. It is a traditionally successful approach, especially when it comes to imparting patient-doctor relationship skills and knowledge on clinical management.Peyton's four-step approach (PFSA) is one of the newer structured instructional approaches for teaching-learning, especially for imparting procedural and complex psychomotor skills.The present study compares the application of PFSA in teaching complex systemic examination skills to the CBT technique in teaching the same skill to MBBS students. The impact of the acquisition of this examination skill was assessed statistically to compare PFSA and CBT methodologies. The target population was MBBS (Bachelor of Medicine and Bachelor of Surgery)students; for this study, the phase II MBBS students were considered as the study population since they were relatively naïve to clinical bedside examination skills. Students were allotted groups and they were taught clinical skills through CBT and PFSA separately. Using the OpenEpi toolkit Version 3 open-source sample size calculator for comparing two means, the sample size was 30 students in each group. The students were assessed for their competency and were also made to fill out a feedback questionnaire to compare the two methods of education dispensing. Results: The results of this study showed that PFSA is definitely suitable for teaching clinical examination skills. The acquisition of skills was found non-inferior to CBT while the retention of these skills was found to be equally good or even superior with PFSA than with CBT. Conclusion:PFSA has already been proven to be a good teaching method for the acquisition of complex procedural skills. This study expands the role of PFSA in teaching clinical bedside examination skills to medical students.Further large-scale studies may clarify the learning impact and outcomes of PFSA in clinical bedside teaching.

Effects of simulation-based flipped classroom in developing head and neck examination skills in dental students.

To evaluate the effectiveness of a simulation-based flipped classroom in developing dental students' head and neck examination skills. Second-year dental students (n=118) participated in a simulation-based flipped classroom experience. A pre-class recorded lecture and video were posted online one week before the simulation date. In class, students completed a pre-quiz assessing pre-class coursework understanding of head and neck examination content. Then, students attended a question-and-answer session before the patient simulation. A formative assessment of head and neck examination simulation on a patient in the clinic was completed. Lastly, students completed an in-class post-quiz assessing understanding of head and neck examination content after the simulation, classroom simulation discussion, and open-response survey. Student post-quiz scores were significantly higher than pre-quiz scores, with an average improvement of 4.8 ± 7.2 percentage points. There was no difference between male and female improvement in scores. Student survey responses indicated that students liked combining simulation and flipped classroom methodology, flexibility with their schedules, learning at their pace, and opportunities for a deeper level of learning. Students reported wanting more practice sessions for their technical skills and more accessibility to faculty. According to this study's results, students had significantly higher post-quiz scores than pre-quiz scores and reported positive perceptions of this combined teaching technique. A simulation-based flipped classroom might be an effective teaching approach for developing head and neck examination skills that can be applied at other dental facilities with potentially similar results.

Establishing Norms Levels For Physical Fitness For The Students Admission Exam In The Physical Education Departments In Palestinians Universities.

&#x0D; The studyinvestigates the possibility of building up standard levels of physical and in testing students who apply for the entrance exam in the faculties of physical education in Palestinian universities . To achieve this goal , the study was conducted on a random sample of 190,174 male and female studentsrespectively in four Palestinian universities ( Al-Najah university ,Khadouri university , Al-Quds Open university and Arab American university – Jenin ).Those students are first- years who underwent ability test in their universities .The tool of the study consists of a number of physical skill examinations that focus on flexibility , agility , speed , muscular strength, fortitude and precision , The data was collected and analysed using the program (spss). The study finds that the students, level in both physical and tactical skill examinations was average. Physical fitness tests for male and female students were founded on standard levels in which the results were illustrated as: flexibility (bending the trunk of the body) , agility (hurdle zigzag race ) , speed ( 30m race ) , fortitude (1500m race), precision ( aiming by the hand at the interlocked circle).The researcher recommends that it is necessary to adopt standard levels the study arrived at in the selection and acceptance of first-year students in the faculties and sections of physical education in Palestinian universities ,provided that there need be a unified system based on scientific standards in all universities in Palestine .&#x0D; &#x0D;

Using simulation to introduce students and healthcare professionals to losses experienced by older adults: a pre-post analysis

BackgroundTo introduce students and healthcare professionals to losses experienced by older adults and instill compassion among interprofessional learners, an interactive narrative simulation activity was developed and incorporated in clinical staff orientation and student professional course work. Narrative simulation allows learners to incorporate skills of examination, exploration, sharing, and reflection applied to simulated losses and lived experience of the older adult to promote empathy and understanding. MethodsA pre-post analysis was conducted to evaluate changes in self-reported empathy scores among nurses, pharmacists, student nurses and student pharmacists using the 20-item Jefferson Scale of Empathy©, Health Professional and Health Professional Student versions. The instrument was administered prior to and after narrative simulation participation.ResultsA total of 152 students and 107 health care professionals completed both assessments. Median (interquartile range, IQR) post-simulation scores were significantly higher among nursing professionals [118.5 (112.25, 126.75) versus 126 (117, 132); P < 0.001; effect size 0.81] and nursing students [116 (107, 121) versus 119 (109, 126); P < 0.001; effect size 0.28], as well as pharmacy students [111 (101, 117) versus 116 (107.5, 125); P < 0.001; effect size 0.47]. Although a moderate effect size of 0.7 was observed for pharmacy professionals, there was no difference between pre- and post-activity empathy scores [117 (98, 137) versus 116 (101, 137); P = 0.16] for pharmacists participating in the narrative simulation exercise.ConclusionsA statistically significant change in self-reported levels of empathy, particularly for nurses, nursing students, and pharmacy students, was observed; results of this activity did not suggest a change in pharmacist self-reported empathy levels. This activity could be implemented by educators seeking to increase awareness of losses experienced by the older adult.

Implementation and assessment of a structured curriculum for a 4-week pediatric rheumatology rotation for pediatric residents

BackgroundGeneral pediatricians often initially address children’s musculoskeletal (MSK) issues and play a crucial role in triaging and managing patients’ rheumatologic conditions. This study assessed the effectiveness of a structured curriculum in enhancing pediatric residents’ knowledge, MSK examination skills, and confidence during a 4-week pediatric rheumatology rotation.MethodsPediatric residents in their either second or third year who participated in the 4-week rheumatology rotation once across three academic years (July 2020–June 2023) were enrolled. Residents’ knowledge, MSK examination skills, and confidence were assessed at pre- and post-rotation by using 25 multiple-choice questions, the Thai pediatric Gait Arms Legs Spine examination, and a questionnaire, respectively. The curriculum comprised instruction on MSK examinations, interactive lectures, case-based discussion, topic reviews, MSK radiology conference, clinical experience in rheumatology clinic and consultations, with self-guided learning with educational resources.ResultsFifty-eight pediatric residents (48 females, 10 males) with a mean age of 28.9 ± 0.8 years participated. Significant improvements were noted postrotation. Knowledge scores rose from 63.0 ± 12.2 to 79.7 ± 9.1 (mean difference 16.7 ± 10.3, p < 0.001). Similarly, MSK examination scores increased from 67.5 ± 14.4 to 93.6 ± 8.7 (mean difference 26.1 ± 14.6, p < 0.001). Residents also reported a marked increase in confidence across all evaluated areas, including history taking, MSK examination, arthrocentesis, and diagnosing and treating rheumatologic conditions (p < 0.001).ConclusionsThe 4-week structured curriculum in the pediatric rheumatology rotation significantly enhanced pediatric residents’ knowledge, MSK examination skills, and confidence. These findings support the integration of pediatric rheumatology rotations into pediatric residency training programs.

Revolutionizing Critical Care Training with Simulation-Based Education

One key principle in healthcare education involves creating teaching and assessment methods that enable instructors to evaluate a trainee’s performance in scenarios mirroring real clinical practice. Standardized patients (SPs) have frequently been employed to evaluate the history-taking and physical examination skills of medical students and practicing physicians.1 Unfortunately, in critical care settings, training and skill development involving real-time patients and situations come with inherent risks and may give rise to numerous ethical concerns. Particularly in the realm of critical care, where rapid decision-making and precise skills are often the difference between life and death, the demand for effective training methods has grown exponentially. While traditional approaches have their merits, there’s a paradigm shift taking place in healthcare education, with simulation-based training emerging as a powerful tool for nurturing the next generation of critical care specialists.2 Simulation-based training in critical care represents a profound leap forward in the way we prepare healthcare professionals for real-world challenges. It’s not just a trend; it’s a revolution, one that’s enhancing the knowledge and skill set of medical personnel and, most importantly, improving patient outcomes. This editorial aims to shed light on the transformative potential of simulation-based training in critical care and its many advantages.

Interprofessional evaluation of "soft skills" of students in the practical year

The present study deals with the implementation of a questionnaire with 360° evaluation to assess the performance of students in the practical year (PJ). A special focus is put on the "soft skills" (self-competence, methodological competence, social competence), whose evaluation in medical studies has not yet taken place comprehensively. The study was conducted prospectively with 21 PJ students of the Medical Faculty of the TU Dresden. The assessment was performed by means of a self-designed questionnaire, which was divided into 4 sub-competencies (self-competence, methodological competence, social competence, clinical skills and abilities), which could be assessed by means of a 6-point Likert scale. Four professions were involved in the assessment: Medical Service, Nursing Service, Functional Service, and Administration. On average, the strongest deficits in terms of self-confidence, willingness to perform, and ability to deal with conflict were revealed by students in the PJ. Students showed a very good performance in performing a medical history and basic skills of clinical examination. The implementation of 360° feedback is possible and useful for students in the internship year across disciplines and professions. Such personal and interprofessional feedback has not been widely available. The questionnaire represents the first comprehensive measurement tool of soft skills for medical students and provides a good basis for comprehensive feedback.

Assessing Abdominal Examination Skills in a Surgery Clerkship Standardized Patient Encounter for Curriculum Improvement.

Standardized patient (SP) encounters allow medical students to practice physical examination skills and clinical reasoning. SP cases are used for learning and assessment, but recorded encounters can also be valuable curriculum evaluation tools. We aimed to review SP encounters to improve abdominal examination skills and the broader physical examination curriculum. We reviewed recorded SP encounters of third-year medical students on surgery clerkship rotation. Students examined a cisgender woman presenting with acute right lower abdominal pain. We observed abdominal examinations to determine which maneuvers were attempted and completed correctly. We then used these outcomes to develop targeted clerkship training for the subsequent student cohort. Our intervention targeted abdominal examination gaps by explaining how to integrate abdominal examination findings with a focused history for surgical patients. We evaluated the intervention's impact on abdominal examination skills with third-year medical students in comparison (2021-2022, n = 119) and intervention (2022-2023, n = 132) groups. In both the comparison and intervention groups, nearly all students attempted at least 1 general examination maneuver like auscultation, palpation, percussion, or rebound tenderness. Only 40% of students in the comparison group attempted an advanced maneuver like the Rovsing, Psoas, or Obturator sign. After the intervention, 75% of students in the intervention group attempted an advanced maneuver (χ2(1, 251) = 31.0, p < .001). Cohorts did not gain skills over time through the clerkship. Rebound tenderness was frequently assessed incorrectly by students in both groups, with many avoiding the right lower quadrant entirely. This project highlights how medical students struggle to utilize abdominal examination maneuvers and integrate findings. The results also showed that students did not consistently learn advanced examination skills either before or during clerkship rotation, which may be commonly assumed by clinical faculty. Finally, this work demonstrates how SP encounters can be used to evaluate and improve surgical education curriculum.