Development of physical examination skills in a third-year surgical clerkship.
BACKGROUND
Previous studies have revealed deficiencies in physical examination (PE) skills of third-year medical students. The purpose of this study was to determine if formal teaching of PE skills and more supervised experiences with clinical faculty would increase the competency of these skills.


METHODS
Forty-nine third-year medical students were assigned to one of two groups: group A was given formal instruction on PE skills at the beginning of the clerkship, and group B received the same instruction at the midpoint of the clerkship. The two groups received an assessment of the PE skills before, in the middle, and at the end of clerkship, utilizing a physician-developed checklist.


RESULTS
Group A had a pretest score of 57.7%. Group B scored 59.8% on the pretest. Independent groups t tests were used to compare the two groups. At the midterm examination, group A increased their score to 71.0%, while group B decreased their score to 55.6%. From beginning to final, both groups had significant improvements in all areas, with group A scoring an overall mean of 75.1% (P = 0.0001), and group B scoring 75.5% (P = 0.0001).


CONCLUSIONS
These findings show the effectiveness of structured learning situations for improving third-year surgery students' PE skills. There is also an indication that usual clerkship activities may not enhance learning of PE skills.
Schwind
C J
CJ
Department of Surgery, Southern Illinois University School of Medicine, P.O. Box 19638, Springfield, IL 62794-9638, USA.
Boehler
M L
ML
Folse
R
R
Dunnington
G
G
Markwell
S J
SJ
D002982:Clinical Clerkship; D002983:Clinical Competence; D004522:Educational Status; D013502:General Surgery / Q000193:education*; D006801:Humans; D010808:Physical Examination; D013663:Teaching / Q000379:methods*