Original Publication
Open Access

Teaching Physical Exam Skills to Novices: Developing all the Tools in the Clinician Toolbox

Published: March 20, 2015 | 10.15766/mep_2374-8265.10057

Included in this publication:

  • Instructor Guide.docx
  • The Stethoscope and Draping.pptx
  • Surface Anatomy Guides.pdf
  • 1 Vitals signs.docx
  • 2 The HEENT Neck Exam.docx
  • 3 The Cardiopulmonary Exam.docx
  • 4 The Abdominal Exam .docx
  • 6 The Musculoskeletal Exam .docx
  • 7 The Neurologic Exam.docx
  • 8 The Complete Physical Exam .docx
  • Vital Signs.mp4
  • The HEENT Neck Exam.mp4
  • The cardiopulmonary exam male patient.mp4
  • The cardiopulmonary exam female patient.mp4
  • The abdominal exam.mp4
  • The Musculoskeletal Exam.mp4
  • The Neurologic Exam.mp4

To view all publication components, extract (i.e., unzip) them from the downloaded .zip file. This publication includes large downloadable files. If you experience difficulty downloading these files, please contact mededportal@aamc.org to receive a free DVD version via mail.


Editor's Note: This publication predates our implementation of the Educational Summary Report in 2016 and thus displays a different format than newer publications.

Abstract

This resource is designed for use within a preclinical skills course to teach first and second-year medical students fundamental physical exam (PE) skills. PE skills are a vital competency for medical students to master. Since bedside teaching of the PE during clerkships is infrequent, students entering clerkships must have a strong foundation in PE skills that will enable them to function autonomously. Methods: This resource helps students develop all the essential tools in their clinician PE toolbox. Students first learn a head-to-toe exam with associated provocative tests according to detailed checklists and PE videos that provide significant scaffolding for the novice learner. While detailed, the checklists and videos are designed to emphasize flexibility, and can expand or contract to a core exam based on what is needed for patient care. Once students have a firm foundation of PE skills, they can begin to learn to select the appropriate tools for the job by learning to perform hypothesis-driven physical exams as support is gradually diminished. Results: The PE checklists and videos have been refined based on student and faculty feedback in an iterative process over more than 10 years of use at the Warren Alpert Medical School of Brown University. The color-coding schema with core/provocative tests was introduced last year and received very favorably. The effectiveness of physical exam instruction is consistently ranked at Brown as very good (4.7 out of 6.0 in 2014) on a scale from poor to outstanding. Discussion: Clinical skills course directors wishing to develop a physical exam thread or seeking to improve their current PE instruction are likely to find this resource valuable. Although this resource was designed for medical students, physician assistant or nurse practitioner training programs may also find it useful.


Educational Objectives

By the end of this resource, learners will be able to:

  1. Demonstrate appropriate physical exam techniques.
  2. Gather accurate clinical data from the physical exam.
  3. Utilize economy of motion for both the provider and the patient when performing the physical exam (i.e. is well organized).
  4. Perform a physical exam that demonstrates respect for the patient with attention to draping and modesty.

Author Information

  • Michelle Daniel, MD: The Warren Alpert Medical School of Brown University
  • Steven Rougas: The Warren Alpert Medical School of Brown University
  • Sarita Warrier: The Warren Alpert Medical School of Brown University
  • Ramin Tabaddor: The Warren Alpert Medical School of Brown University
  • Kirsta Bray: The Warren Alpert Medical School of Brown University
  • Julie Taylor: The Warren Alpert Medical School of Brown University

Disclosures
None to report.

Funding/Support
None to report.



Citation

Daniel M, Rougas S, Warrier S, Tabaddor R, Bray K, Taylor J. Teaching physical exam skills to novices: developing all the tools in the clinician toolbox. MedEdPORTAL. 2015;11:10057. https://doi.org/10.15766/mep_2374-8265.10057