Teaching students the art and science of physical diagnosis

https://doi.org/10.1016/S0002-9343(01)00621-0Get rights and content

Section snippets

Barrier 1: lack of bedside ward teaching for medical students

Faculty on wards are not teaching at the bedside. LaCombe (8) reported that actual teaching at the bedside has declined from an incidence of 75% in the 1960s to less than 16% today. In a survey of students completing a medicine clerkship at one medical school, students reported that they were observed examining an inpatient by an attending physician an average of 1.6 times in 8 weeks of inpatient medicine (personal communication). Bedside teaching provides a forum for internists to demonstrate

Recommendations for departmental and institutional support for teaching physical diagnosis

Overcoming barriers to teaching and evaluating physical diagnosis requires a department-wide initiative. Although this cannot be expected to occur overnight, a clerkship director or director of the introduction to physical examination course can promote innovative solutions with the support of the department chair, the medical school dean’s office, and other clerkship directors.

Medical schools should reward the teacher of physical diagnosis by acknowledging teaching efforts through personal

Conclusions

The physical examination is a useful diagnostic tool and a key component of the patient-physician interaction. With the emergence of new resources and technologies, complemented by traditional teaching methods, this is a fortuitous time to pursue the development, implementation, and evaluation of advanced physical diagnosis curriculum for medical students. Faculty should use existing time more effectively and efficiently to teach physical diagnosis. Faculty development and workshops about

Acknowledgements

The authors thank Deborah Simpson, PhD, Associate Dean for Educational Services at Medical College of Wisconsin, for helpful suggestions for this manuscript.

First page preview

First page preview
Click to open first page preview

References (15)

  • B.M Belkin et al.

    The art of observationWilliam Osler and the method of Zadig

    Ann Intern Med

    (1992)
  • S Mangione et al.

    Cardiac auscultatory skills among internal medicine and family practice traineesa comparison of diagnostic proficiency

    Chest

    (1996)
  • Dunnington G, Reisner E, Witzke D, et al. Teaching and evaluation of physical examination skills on the surgical...
  • D.S Paauw et al.

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

    JAMA

    (1995)
  • Society of General Internal Medicine and Clerkship Directors in Internal Medicine. Core Medicine Clerkship Curriculum...
  • Bass EB, Fortin AH, Morrison G, et al. National survey of clerkship directors in internal medicine on the competencies...
  • Association of American Medical Colleges. Learning Objectives for Medical Student Education—Guidelines for Medical...
There are more references available in the full text version of this article.

Cited by (0)

1

Dr. Anderson is Associate Program Director in the Department of Medicine at the Medical College of Wisconsin.

2

. Fagan is the Third Year Clerkship Director in the Department of Medicine at Brown University School of Medicine.

3

Dr. Sebastian is Director of Student Teaching Programs for the Department of Medicine at the Medical College of Wisconsin.

View full text