Short Communication: Final Year Students’ Deficits in Physical Examination Skills Performance in Germany

Krautter, Markus; Diefenbacher, Katja; Koehl-Hackert, Nadja; Buss, Beate; Nagelmann, Lars; Herzog, Wolfgang; Jünger, Jana; Nikendei, Christoph

doi:10.1016/j.zefq.2015.01.003

Cited by 18 publications

(23 citation statements)

References 4 publications

(5 reference statements)

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“…Other studies have yielded similar results [8], [12], [13], [26], [41]. Although the publications cited originated abroad, similar results are to be expected among German medical students [25]. But what are the reasons for this lack of physical examination skills?…”

Section: Introductionsupporting

confidence: 56%

FAMULATUR PLUS – A successful model for improving students' physical examination skills?

Jerg

Öchsner

Traue

et al. 2017

GMS Journal for Medical Education; 34(2):Doc20

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Section: Introductionsupporting

confidence: 56%

FAMULATUR PLUS – A successful model for improving students' physical examination skills?

Jerg

Öchsner

Traue

et al. 2017

GMS Journal for Medical Education; 34(2):Doc20

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“…The feedback of the PI and the physician was then content-analyzed by two different independent video assessors based on a provided checklist. Finally, the results were compared to an objective performance standard as previously described elsewhere [4,32,33]. …”

Section: Methodsmentioning

confidence: 99%

“…Twelve dyads performed three sessions, while two dyads performed two sessions, resulting in 40 sessions with 40 student participants overall. The students were given role-playing instructions asking them to perform a pre-employment medical check-up of a PI, including a detailed physical examination of the cardiovascular system, the lungs, the abdomen and the thyroid gland [4]. In line with normal teaching situation procedure, during the examination of the respective PI, the physician was able to make notes on mistakes made by the student on a provided checklist.…”

Section: Methodsmentioning

confidence: 99%

“…However, several studies indicate severe shortcomings in students’ physical examination competencies [2,3]. In a recent study, we revealed significant deficits in the ability of final-year medical students to perform a detailed physical examination of standardized patients [4], with only 63% of correctly performed procedural steps. However, the manner in which physical examination skills should be delivered is still subject to discussion [5–7].…”

Section: Introductionmentioning

confidence: 99%

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Physical examination skills training: Faculty staff vs. patient instructor feedback—A controlled trial

et al. 2017

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BackgroundStandardized patients are widely used in training of medical students, both in teaching and assessment. They also frequently lead complete training sessions delivering physical examination skills without the aid of faculty teaching staff–acting as “patient instructors” (PIs). An important part of this training is their ability to provide detailed structured feedback to students which has a strong impact on their learning success. Yet, to date no study has assessed the quality of physical examination related feedback by PIs. Therefore, we conducted a randomized controlled study comparing feedback of PIs and faculty staff following a physical examination assessed by students and video assessors.Methods14 PIs and 14 different faculty staff physicians both delivered feedback to 40 medical students that had performed a physical examination on the respective PI while the physicians observed the performance. The physical examination was rated by two independent video assessors to provide an objective performance standard (gold standard). Feedback of PI and physicians was content analyzed by two different independent video assessors based on a provided checklist and compared to the performance standard. Feedback of PIs and physicians was also rated by medical students and video assessors using a questionnaire consisting of 12 items.ResultsThere was no statistical significant difference concerning overall matching of physician or PI feedback with gold standard ratings by video assessment (p = .219). There was also no statistical difference when focusing only on items that were classified as major key steps (p = .802), mistakes or parts that were left out during physical examination (p = .219) or mistakes in communication items (p = .517). The feedback of physicians was significantly better rated than PI feedback both by students (p = .043) as well as by video assessors (p = .034).ConclusionsIn summary, our study demonstrates that trained PIs are able to provide feedback of equal quantitative value to that of faculty staff physicians with regard to a physical examination performed on them. However, both the students and the video raters judged the quality of the feedback given by the physicians to be significantly better than that of the PIs.

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“…A study among students in the Practical Year (PY) at a German university revealed that in the physical examination of four important organ systems, only 40% of the students (thyroid 38%, heart 37%, lungs 42%, abdomen 43%) correctly implemented the a priori defined relevant sub-steps [10]. Likewise, in the interpretation of cardiac and pulmonary auscultation findings [11], pathological findings were only correctly classified in 20 - 45% of cases, which can be seen as posing a considerable danger for misdiagnosis [6].…”

Section: Introductionmentioning

confidence: 99%

“Heidelberg standard examination” and “Heidelberg standard procedures” – Development of faculty-wide standards for physical examination techniques and clinical procedures in undergraduate medical education

Nikendei

Ganschow

Groener

et al. 2016

GMS Journal for Medical Education; 33(4):Doc54

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Short Communication: Final Year Students’ Deficits in Physical Examination Skills Performance in Germany

Cited by 18 publications

References 4 publications

FAMULATUR PLUS – A successful model for improving students' physical examination skills?

FAMULATUR PLUS – A successful model for improving students' physical examination skills?

Physical examination skills training: Faculty staff vs. patient instructor feedback—A controlled trial

“Heidelberg standard examination” and “Heidelberg standard procedures” – Development of faculty-wide standards for physical examination techniques and clinical procedures in undergraduate medical education

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