Literature DB >> 12911648

Improving the physical diagnosis skills of third-year medical students: a controlled trial of a literature-based curriculum.

Mark J Fagan1, Rebecca A Griffith, Laura Obbard, Carolyn J O'Connor.   

Abstract

OBJECTIVE: To determine if a literature-based physical diagnosis curriculum could improve student knowledge, skill, and self-confidence in physical diagnosis.
DESIGN: Prospective controlled trial of an educational intervention.
SETTING: Required internal medicine clerkship for third-year medical students at Brown Medical School. PARTICIPANTS: Third-year medical students who completed the internal medicine clerkship during the academic year 1999-2000: 32 students at 1 clerkship site received the intervention; a total of 50 students at 3 other clerkship sites served as controls. INTERVENTION: Physical diagnosis curriculum based on 8 articles from the Journal of the American Medical Association's Rational Clinical Examination series. Intervention students met weekly for 1 hour with a preceptor to review each article, discuss the sensitivity and specificity of the maneuvers and findings, and practice the techniques with an inpatient who agreed to be visited and examined.
MEASUREMENTS AND MAIN RESULTS: Physical diagnosis knowledge for the 8 topics was evaluated using a 22-item multiple choice question quiz, skill was evaluated using trained evaluators, and self-confidence was assessed using an end-of-clerkship survey. Intervention students scored significantly higher than the control group on the knowledge quiz (mean correct score 70% vs 63%, P =.002), skills assessment (mean correct score 90% vs 54%, P <.001), and self-confidence score (mean total score 40 vs 35, P =.003), and they expressed greater satisfaction with the physical diagnosis teaching they received in the clerkship.
CONCLUSION: This physical diagnosis curriculum was successful in improving students' knowledge, skill, and self-confidence in physical diagnosis.

Entities:  

Mesh:

Year:  2003        PMID: 12911648      PMCID: PMC1494895          DOI: 10.1046/j.1525-1497.2003.20821.x

Source DB:  PubMed          Journal:  J Gen Intern Med        ISSN: 0884-8734            Impact factor:   5.128


  15 in total

Review 1.  What can the history and physical examination tell us about low back pain?

Authors:  R A Deyo; J Rainville; D L Kent
Journal:  JAMA       Date:  1992-08-12       Impact factor: 56.272

Review 2.  The rational clinical examination. Does this patient have ascites? How to divine fluid in the abdomen.

Authors:  J W Williams; D L Simel
Journal:  JAMA       Date:  1992-05-20       Impact factor: 56.272

Review 3.  Physical diagnosis in the 1990s. Art or artifact?

Authors:  S Mangione; S J Peitzman
Journal:  J Gen Intern Med       Date:  1996-08       Impact factor: 5.128

4.  The rational clinical examination. Does this patient have splenomegaly?

Authors:  S A Grover; A N Barkun; D L Sackett
Journal:  JAMA       Date:  1993-11-10       Impact factor: 56.272

5.  The Rational Clinical Examination. Does this patient have abnormal central venous pressure?

Authors:  D J Cook; D L Simel
Journal:  JAMA       Date:  1996-02-28       Impact factor: 56.272

6.  The rational clinical examination. Does this patient have a clinically important carotid bruit?

Authors:  J S Sauvé; A Laupacis; T Ostbye; B Feagan; D L Sackett
Journal:  JAMA       Date:  1993-12-15       Impact factor: 56.272

7.  Development, implementation, and evaluation of an advanced physical diagnosis course for senior medical students.

Authors:  D Berg; J Sebastian; G Heudebert
Journal:  Acad Med       Date:  1994-09       Impact factor: 6.893

8.  Creation and assessment of a structured review course in physical diagnosis for medical residents.

Authors:  S Mangione; S J Peitzman; E Gracely; L Z Nieman
Journal:  J Gen Intern Med       Date:  1994-04       Impact factor: 5.128

9.  The rational clinical examination. Is this patient hypovolemic?

Authors:  S McGee; W B Abernethy; D L Simel
Journal:  JAMA       Date:  1999-03-17       Impact factor: 56.272

10.  Ability of primary care physicians to recognize physical findings associated with HIV infection.

Authors:  D S Paauw; M D Wenrich; J R Curtis; J D Carline; P G Ramsey
Journal:  JAMA       Date:  1995-11-01       Impact factor: 56.272

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  4 in total

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Authors:  Joshua C Denny; Anderson Spickard; Kevin B Johnson; Neeraja B Peterson; Josh F Peterson; Randolph A Miller
Journal:  J Am Med Inform Assoc       Date:  2009-08-28       Impact factor: 4.497

2.  Improving diagnosis in healthcare: Local versus national adoption of recommended guidelines for the clinical breast examination.

Authors:  Jay N Nathwani; Anna Garren; Shlomi Laufer; Calvin Kwan; Carla M Pugh
Journal:  Am J Surg       Date:  2017-12-05       Impact factor: 2.565

3.  Formal art observation training improves medical students' visual diagnostic skills.

Authors:  Sheila Naghshineh; Janet P Hafler; Alexa R Miller; Maria A Blanco; Stuart R Lipsitz; Rachel P Dubroff; Shahram Khoshbin; Joel T Katz
Journal:  J Gen Intern Med       Date:  2008-07       Impact factor: 5.128

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

Authors:  Manuel Burggraf; Julia Kristin; Alexander Wegner; Sascha Beck; Stephanie Herbstreit; Marcel Dudda; Marcus Jäger; Max Daniel Kauther
Journal:  BMC Med Educ       Date:  2018-10-29       Impact factor: 2.463

  4 in total

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