Teaching the physical examination

A longitudinal strategy for tomorrow's physicians

Toshiko Uchida*, Jeanne M. Farnan, Jennifer E. Schwartz, Heather L. Heiman

*Corresponding author for this work

Research output: Contribution to journalReview article

17 Citations (Scopus)

Abstract

The physical examination is an essential clinical skill. The traditional approach to teaching the physical exam has involved a comprehensive "head-to-toe" checklist, which is often used to assess students before they begin their clinical clerkships. This method has been criticized for its lack of clinical context and for promoting rote memorization without critical thinking. In response to these concerns, Gowda and colleagues surveyed a national sample of clinical skills educators in order to develop a consensus "core" physical exam, which they report in this issue. The core physical exam is intended to be performed for every patient admitted by students during their medicine clerkships and to be supplemented by symptom-driven "clusters" of additional history and physical exam maneuvers.In this commentary, the authors review the strengths and limitations of this Core + Clusters technique as well as the head-to-toe approach. They propose that the head-to-toe still has a place in medical education, particularly for beginning students with little knowledge of pathophysiology and for patients with vague or multiple symptoms. The authors suggest that the ideal curriculum would include teaching both the head-to-toe and the Core + Clusters exams in sequence. This iterative approach to physical exam teaching would allow a student to assess a patient in a comprehensive manner while incorporating more clinical reasoning as further medical knowledge is acquired.

Original languageEnglish (US)
Pages (from-to)373-375
Number of pages3
JournalAcademic Medicine
Volume89
Issue number3
DOIs
StatePublished - Jan 1 2014

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Toes
Physical Examination
Teaching
Head
physician
Students
Physicians
examination
Clinical Competence
Clinical Clerkship
student
Medical Education
Checklist
Curriculum
Consensus
History
Medicine
medicine
educator
curriculum

ASJC Scopus subject areas

  • Education

Cite this

Uchida, Toshiko ; Farnan, Jeanne M. ; Schwartz, Jennifer E. ; Heiman, Heather L. / Teaching the physical examination : A longitudinal strategy for tomorrow's physicians. In: Academic Medicine. 2014 ; Vol. 89, No. 3. pp. 373-375.
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Teaching the physical examination : A longitudinal strategy for tomorrow's physicians. / Uchida, Toshiko; Farnan, Jeanne M.; Schwartz, Jennifer E.; Heiman, Heather L.

In: Academic Medicine, Vol. 89, No. 3, 01.01.2014, p. 373-375.

Research output: Contribution to journalReview article

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