Improving the physical diagnosis skills of third-year medical students

Fagan, Mark J.; Griffith, Rebecca A.; Obbard, Laura; O'Connor, Carolyn

doi:10.1046/j.1525-1497.2003.20821.x

Cited by 24 publications

(15 citation statements)

References 20 publications

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“…These results are further supported by the moderate effect sizes achieved by the intervention group in the musculoskeletal and GI stations, suggesting that the differences found between groups have clinical significance. We believe these differences are a reflection of the directed bedside teaching intervention and are consistent with the findings of others demonstrating the benefits of dedicated instruction in physical examination skills, either at the bedside or in a setting with standardized patients (Fagan et al 2003;Fox et al 2001;Gale and Gale 2006;Junger et al 2005;Schwind et al 2001). Students were randomly assigned to the medicine clerkship sites prior to the beginning of their 3rd year.…”

Section: Discussionsupporting

confidence: 61%

Development, impact, and measurement of enhanced physical diagnosis skills

Smith

Burton

Mackay

2008

Adv in Health Sci Educ

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Evidence suggests that the quality and frequency of bedside clinical examination have declined. We undertook the study to (1) determine whether intensive instruction in physical examination enhances medical student skills and (2) develop a tool to evaluate those skills using a modified observed structured clinical examination (OSCE). This was a randomized, blinded, prospective, year-long study involving 3rd year students at the Albert Einstein College of Medicine. Students were randomized to receive intensive instruction in physical examination [study group (n = 46)] or usual instruction [control group (n = 75)] and evaluated by a modified OSCE. The OSCE consisted of 6 real patient stations: Head, ears, eyes, neck, throat; pulmonary; cardiovascular; gastrointestinal; neurology; musculoskeletal; and 2 computer imaging stations: genitourinary and dermatology. A faculty member present at each patient station evaluated student performance. Data were analyzed using t-tests for comparison of the mean scores between the two groups for each station and for average scores across stations. A total of 121 students were tested. The study group performed significantly better than the control group in the gastrointestinal station (p = 0.0004), the combined average score across the six real patient stations (p = 0.0001), and the combined average score across all eight stations (p = 0.0014). Intensive physical diagnosis instruction enhances physical examination skills of 3rd year medical students. The modified OSCE is a useful tool to evaluate these skills.

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Section: Discussionsupporting

confidence: 61%

Development, impact, and measurement of enhanced physical diagnosis skills

Smith

Burton

Mackay

2008

Adv in Health Sci Educ

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“…Acquired physical examination skills are known to be of lasting value. Data suggests that even greater emphasis should be placed on basic clinical skills [ 1 , 2 ]. In recent years, there has been a trend in medical curricula away from classical teacher-centred lectures towards clinical skills courses including peer physical examinations by students as well as bedside teaching.…”

Section: Introductionmentioning

confidence: 99%

Willingness of medical students to be examined in a physical examination course

et al. 2018

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BackgroundPhysical examination courses are an essential part of the education of medical students. The aim of this study was to ascertain the factors influencing students’ motivation and willingness to participate in a physical examination course.MethodsStudents were asked to complete a questionnaire subdivided into five domains: anthropometric data, religiousness, motivation to take part in physical examination courses, willingness to be physically examined at 11 different body regions by peers or a professional tutor and a field for free text.ResultsThe questionnaire was completed by 142 medical students. The importance of the examination course was rated 8.7 / 10 points, the score for students’ motivation was 7.8 / 10 points. Willingness to be physically examined ranged from 6 to 100% depending on body part and examiner. Female students were significantly less willing to be examined at sensitive body parts (breast, upper body, groin and the hip joint; p = .003 to < .001), depending on group composition and / or examiner. Strictly religious students showed significantly less willingness to undergo examination of any part of the body except the hand (p = .02 to < .001). Considering BMI, willingness to be examined showed comparable rates for normal weight and under- / overweight students in general (80% vs. 77%). Concerning the composition of the group for physical examination skills courses, students preferred self-assembled over mixed gender and same gender groups.ConclusionsPeer physical examination is a method to improve students’ skills. While motivation to participate in and acceptance of the physical examination course appears to be high, willingness to be examined is low for certain parts of the body, e.g. breast and groin, depending on religiousness, gender and examiner. Examination by a professional medical tutor did not lead to higher acceptance. Most students would prefer to choose their team for physical examination courses themselves rather than be assigned to a group.

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“…In recent years, evidence has shown that the examination skills of medical students and clinicians have deteriorated (Mangione and Peitzman, ; Wenrich et al, ; Oliver et al, ). This is, in part, attributed to a greater reliance on improving imaging technologies and other investigation modalities to diagnose patients, (Dunnington et al, ; Macdessi and Oates, ; Bordage, ; Mangione and Peitzman, ; Tavel, ; Anderson et al, ; Fagan et al, ). Although these advancements are often critical to improving patient care, the number of unnecessary investigations performed on patients has increased, a lot of which could have been avoided by simple examination (Macdessi and Oates, ; Bordage, ).…”

Section: Introductionmentioning

confidence: 99%

Art, anatomy, and medicine: Is there a place for art in medical education?

Bell

Evans

2014

Anatomical Sciences Ed

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For many years art, anatomy and medicine have shared a close relationship, as demonstrated by Leonardo da Vinci's anatomical drawings and Andreas Vesalius' groundbreaking illustrated anatomical textbook from the 16th century. However, in the modern day, can art truly play an important role in medical education? Studies have suggested that art can be utilized to teach observational skills in medical students, a skill that is integral to patient examination but seldom taught directly within medical curricula. This article is a subjective survey that evaluates a student selected component (SSC) that explored the uses of art in medicine and investigates student perception on the relationship between the two. It also investigates whether these medical students believe that art can play a role in medical education, and more specifically whether analyzing art can play a role in developing observational skills in clinicians. An "Art in Medicine" 8-week course was delivered to first year medical students at Brighton and Sussex Medical School. The use of art to improve observational skills was a core theme throughout. Feedback from the students suggests that they believe a strong association between art and medicine exists. It also showed a strong perception that art could play a role in medical education, and more specifically through analyzing art to positively develop clinical observational skills. The results of this subjective study, together with those from research from elsewhere, suggest that an art-based approach to teaching observational skills may be worth serious consideration for inclusion in medical and other healthcare curricula.

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Improving the physical diagnosis skills of third-year medical students

Abstract: This physical diagnosis curriculum was successful in improving students' knowledge, skill, and self-confidence in physical diagnosis.

Cited by 24 publications

References 20 publications

Development, impact, and measurement of enhanced physical diagnosis skills

Development, impact, and measurement of enhanced physical diagnosis skills

Willingness of medical students to be examined in a physical examination course

Art, anatomy, and medicine: Is there a place for art in medical education?

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