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. 2019 Dec;24(1):1608142.
doi: 10.1080/10872981.2019.1608142.

How do novices learn physical examination skills? A systematic review of the literature

Aaron R Danielson  1 , Sandhya Venugopal  2 , Jason M Mefford  3 , Samuel O Clarke  1
Affiliations

How do novices learn physical examination skills? A systematic review of the literature

Aaron R Danielson et al. Med Educ Online. 2019 Dec.

Abstract

Background: Physical Examination (PE) skills are vital for patient care, and many medical students receive their first introduction to them in their pre-clinical years. A substantial amount of curriculum time is devoted to teaching these skills in most schools. Little is known about the best way to introduce PE skills to novice learners.

Objective: Our objective was to conduct a systematic review of how medical students are first taught PE skills and the evidence supporting these strategies.

Design: We searched ERIC, SCOPUS, MEDLINE, PubMed and EMBASE for descriptions of complete PE curricula for novice learners. Inclusion criteria were: (1) English language; (2) subjects were enrolled in medical school and were in the preclinical portion of their training; (3) description of a method to teach physical examination skills for the first time; (4) description of the study population; (5) Description of a complete PE curriculum. We used the Medical Education Research Study Quality Instrument (MERSQI) score to evaluate the quality of evidence provided.

Results: Our search returned 5,418 articles; 32 articles met our inclusion criteria. Two main types of curricula were reported: comprehensive 'head-to-toe' PE curricula (18%) and organ system-based curricula (41%). No studies compared these directly, and only two evaluated trainees' clinical performance. The rest of the articles described interventions used across curricula (41%). Median MERSQI score was 10.1 Interquartile range 8.1-12.4. We found evidence for the use of non-faculty teaching associates, technology-enhanced PE education, and the addition of clinical exposure to formal PE teaching.

Conclusions: The current literature on teaching PE is focused on describing innovations to head-to-toe and organ system-based curricula rather than their relative effectiveness, and is further limited by its reliance on short-term outcomes. The optimal strategy for novice PE instruction remains unknown.

Keywords: Systematic review; medical student; physical examination; preclinical; teaching.

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Figures

Figure 1.
Figure 1.
Selection process used in a systematic review of preclinical medical student physical examination curricula published through 1 January 2015.
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References

    1. Chen HC, McNamara M, Teherani A, et al. Developing entrustable professional activities for entry into clerkship. Acad Med. 2016;91(2):247–14. - PubMed
    1. Swing SR. The ACGME outcome project: retrospective and prospective. Med Teach. 2007;29(7):648–654. - PubMed
    1. Craige E. Should auscultation be rehabilitated? N Engl J Med. 1988;318(24):1611–1613. - PubMed
    1. Mangione S, Nieman LZ. Pulmonary auscultatory skills during training in internal medicine and family practice. Am J Respir Crit Care Med. 1999;159(4 Pt 1):1119–1124. - PubMed
    1. Nadoolman W. Cardiac auscultation skills of physicians in training. Jama. 1997;278(21): 1739 author reply 41. - PubMed

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