Assessing physical examination skills of senior medical students: knowing how versus knowing when.
OBJECTIVE
Literature has documented a lack of physical examination proficiency among medical students. To investigate UCLA medical students' physical examination proficiency, this study compared their performance on a multiple-station Clinical Performance Examination (CPX) focused on clinical cases with that on a thorough physical examination objective structured clinical examination (OSCE) of the same organ systems.


METHODS
One hundred sixty-three beginning fourth-year students participated in the study. Four organ systems were included in both the CPX and OSCE. Pearson's correlation coefficients and paired-sample t-tests were conducted to determine the correlations between and differences in the two tests.


RESULTS
The physical examination scores on the CPX were significantly (p <.001) lower both by organ subscale and in total than those on the OSCE. Correlation coefficients between the two tests were negligible.


CONCLUSIONS
The study suggests that fourth-year medical students may demonstrate competency in directed examination of organ systems while being unable to correctly apply those examination skills to the work-up of clinical cases.
Wilkerson
LuAnn
L
David Geffen School of Medicine at UCLA, Los Angeles, CA 90095-1722, USA. lwilkerson@mednet.ucla.edu
Lee
Ming
M
D002140:California; D002983:Clinical Competence / Q000592:standards*; D003198:Computer Simulation; D004504:Education, Medical, Undergraduate / Q000592:standards; D004521:Educational Measurement; D006801:Humans; D010808:Physical Examination / Q000592:standards*; D013337:Students, Medical