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

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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.

Original languageEnglish (US)
Article number1608142
JournalMedical Education Online
Volume24
Issue number1
DOIs
StatePublished - Jan 1 2019

Keywords

  • medical student
  • physical examination
  • preclinical
  • Systematic review
  • teaching

ASJC Scopus subject areas

  • Education

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