Physical examination in undergraduate medical education in the field of general practice – a scoping review

Moßhammer, Dirk; Graf, Joachim; Joos, Stefanie; Hertkorn, Rebekka

doi:10.1186/s12909-017-1074-1

Cited by 15 publications

(15 citation statements)

References 85 publications

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“…The high level of diversification in the programs is consistent with previous studies that evaluated physical examination education for undergraduate medical students 29,30 . In addition, a review by Easton and colleagues found several medical models for teaching physical assessment in the published literature, but a general absence of evidence to support the superiority of one model over another 31 .…”

Section: Discussionsupporting

confidence: 81%

Physical assessment educational programs for pharmacists and pharmacy students: A systematic review

Barry

Turgeon

Ellis

2020

J Am Coll Clin Pharm

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Introduction The scope of pharmacy practice has evolved to include physical assessment (PA) as part of the management of drug therapy. Objective To describe programs developed to teach pharmacists/pharmacy students PA and identify factors associated with improved knowledge, skill, confidence, and utilization. Methods A librarian‐assisted search was performed of MEDLINE, Embase, and Cumulative Index to Nursing and Allied Health Literature using the terms “pharmacist,” “student,” and “physical examination,” supplemented with manual reference searches. Studies published exclusively as abstracts were excluded. No language restrictions were applied. Extracted data included design, location, participants, methods of instruction, PA skills taught, assessment, utilization, and follow‐up. Results The search yielded 635 unique citations, which were independently reviewed by two authors. Twenty‐eight articles were reviewed in full and 16 were included. Most studies were conducted in the United States or Canada. Thirteen studies enrolled pharmacy students (mainly second or third year), which focused on comprehensive PA skills or blood pressure measurement. Length of instruction ranged from a single session to a full‐year course. Generally, any type of instruction improved knowledge and confidence with PA. Students preferred pharmacist instructors to other clinicians, and live subjects to simulators/manikins. Three studies evaluated courses for practicing pharmacists, which included comprehensive PA instruction and consisted of 2‐30 contact hours. Participants' confidence with performing PA improved from precourse to postcourse surveys. One study showed improved confidence with performing PA 6 months after the course, while another study showed no improvement in confidence but increased PA use at 6 months postcourse. Utilization of PA after 6 months ranged from 49% to 66%. Conclusions A variety of programs have been developed to teach PA skills to pharmacists/pharmacy students. Limited data suggest that sessions which included pharmacist instructors and live subjects to practice PA skills were preferred. Courses for practicing pharmacists improved confidence with performing PA, but persistent confidence and utilization at 6 months were variable.

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Section: Discussionsupporting

confidence: 81%

Physical assessment educational programs for pharmacists and pharmacy students: A systematic review

Barry

Turgeon

Ellis

2020

J Am Coll Clin Pharm

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“…As good communication skills are crucial for doctorpatient interactions, it is recommended to incorporate them in medical school programs from the very beginning [14,15]. Despite ongoing debate about the importance of improving medical students' and fully trained physicians' communication skills, structured communication skills (e.g., for the training of history-talking and teaching of physical examination [16]) are still underprovided in Germany [17][18][19][20][21][22]. Since introduction of the latest medical licensure act in Germany (2002), which requires training and examination of social, communications, and interpersonal skills in the teaching of prospective physicians, German medical faculties are faced with the challenges of implementing practical examinations and reducing the influence of written and oral exams [23,24].…”

Section: Communication Skills Of Medical Studentsmentioning

confidence: 99%

Communication skills of medical students: survey of self- and external perception in a longitudinally based trend study

Graf¹,

Loda²,

Zipfel³

et al. 2020

BMC Med Educ

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Background: As good communication skills are crucial for doctor-patient interactions, it is recommended to incorporate them in medical school programs from the very beginning. On this basis medical schools in Germany introduced the OSCE (objective structured clinical examination) to examine and by this foster learning of communication skills as assessment drives learning. The aim of the study was to examine the development of the communication skills of medical students during an OSCE to investigate how communication competence has developed between different student cohorts. Methods: This study is a longitudinal trend study based on seven semester-cohorts, examining the communication skills of medical students in the OSCE both from the perspective of students and from the viewpoint of standardized patients (SP). Altogether, 1027 students from seven semester cohorts were asked to rate their own communication skills (self-perception) before the OSCE exam started. Here, sub-analyses were performed to outline a potential influence of previous history-taking group participation. The SP evaluated the students' communication skills in external perception during the OSCE exam at each station with history-taking or physical examinations. The communication skills in both groups were ascertained in the dimensions of empathy, content structure, verbal expression, and non-verbal expression. Results: Only in the dimension of non-verbal expression could a statistically significant change be found in students' self-perception over the years. Notably, the rating of communication skills as self-rated by the students has risen constantly, whereas they deteriorated from the perspective of standardized patients (SP). It has also been found that previous history-taking courses have a positive influence on the structural dimension of communication skills in particular. Conclusions: The results of this study support conclusions of other studies which also suggest differences between self-and external perception of medical students' communication skills. Nevertheless, students showed good overall communication skills in the four dimensions of empathy, content structure, verbal expression, and non-verbal expression, as demonstrated in a longitudinal trend study over seven semesters. However, we noted that externally rated empathy levels declined over the semester cohorts, suggesting the need for new priorities to be set in student teaching.

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“…Mookherjee et al describe the state of PE instruction in graduate medical education (GME) [10] and Easton et al describe underlying educational theory in teaching PE skills in a narrative review [11]. Recently, Moßhammer et al published a scoping review describing how PE is taught in general practice [12]. However, a systematic review of the literature describing approaches to teaching PE skills to novice medical students is currently lacking.…”

Section: Introductionmentioning

confidence: 99%

“…While Moßhammer et al describe teaching methodology in their review they did not describe the overall curriculum design in which these methodologies were used. Their scope also included interventions applied to learners at all phases of undergraduate medical education training [12].…”

Section: Introductionmentioning

confidence: 99%

How do novices learn physical examination skills? A systematic review of the literature

Danielson

Venugopal

Mefford

et al. 2019

Medical Education Online

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Background: Physical Examination (PE) skills are vital for patient care, and many medical students receive their first introduction to them in their pre-clinical years. A substantial amount of curriculum time is devoted to teaching these skills in most schools. Little is known about the best way to introduce PE skills to novice learners. Objective: Our objective was to conduct a systematic review of how medical students are first taught PE skills and the evidence supporting these strategies. Design: We searched ERIC, SCOPUS, MEDLINE, PubMed and EMBASE for descriptions of complete PE curricula for novice learners. Inclusion criteria were: (1) English language; (2) subjects were enrolled in medical school and were in the preclinical portion of their training; (3) description of a method to teach physical examination skills for the first time; (4) description of the study population; (5) Description of a complete PE curriculum. We used the Medical Education Research Study Quality Instrument (MERSQI) score to evaluate the quality of evidence provided. Results: Our search returned 5,418 articles; 32 articles met our inclusion criteria. Two main types of curricula were reported: comprehensive 'head-to-toe' PE curricula (18%) and organ system-based curricula (41%). No studies compared these directly, and only two evaluated trainees' clinical performance. The rest of the articles described interventions used across curricula (41%). Median MERSQI score was 10.1 Interquartile range 8.1-12.4. We found evidence for the use of non-faculty teaching associates, technology-enhanced PE education, and the addition of clinical exposure to formal PE teaching. Conclusions: The current literature on teaching PE is focused on describing innovations to head-to-toe and organ system-based curricula rather than their relative effectiveness, and is further limited by its reliance on short-term outcomes. The optimal strategy for novice PE instruction remains unknown.

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Physical examination in undergraduate medical education in the field of general practice – a scoping review

Cited by 15 publications

References 85 publications

Physical assessment educational programs for pharmacists and pharmacy students: A systematic review

Physical assessment educational programs for pharmacists and pharmacy students: A systematic review

Communication skills of medical students: survey of self- and external perception in a longitudinally based trend study

How do novices learn physical examination skills? A systematic review of the literature

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