Teaching physical diagnosis in an ambulatory family medicine setting.

A method of teaching physical diagnosis to second year medical students in an ambulatory family practice setting is described. During tutorial sessions, the tutor demonstrated each step in the physical examination and the students practiced on him or on other students who acted the part of patients. In addition, some newly registered patients in the family practice unit volunteered to allow the students to practice history taking and physical examinations on them. The students then watched the staff physician examine the same patients immediately afterwards. Some of the advantages of teaching physical diagnosis in this way rather than in the traditional ward setting include an emphasis on the practical aspects of family practice; the opportunity for student `examiners' to learn from the advice of student `patients', and the likelihood that early exposure to family medicine units influences students to pick family medicine as a career. A possible disadvantage is that students are unlikely to see many patients with abnormal physical findings in the family practice unit.