title: Does residency training improve performance of physical examination skills?
abstract: BACKGROUND
  Few studies use objective structured clinical examinations (OSCEs) to measure physical examination skills of internal medicine residents. Little is known about performance by year of residency training.
  
  
  OBJECTIVE
  To determine differences between postgraduate year (PGY)-1 and PGY-3 residents on performance and comfort of physical examination skills.
  
  
  METHODS
  In a cross-sectional study, we tested 16 PGY-1 (weeks 0 and 4) and 8 PGY-3 internal medicine residents with a five-station OSCE.
  
  
  RESULTS
  PGY-3 residents performed better than PGY-1 week 0 residents (P = 0.03) but not PGY-1 week 4 residents (P = 0.42). PGY-1 resident performance improved after 1 month of inpatient wards experience (P < 0.001). PGY-3 residents had higher comfort compared to PGY-1 week 0 residents (P = 0.003) but not PGY-1 week 4 residents (P = 0.10).
  
  
  CONCLUSIONS
  Senior residents performed better and were more confident on physical examination skills, but the difference disappeared after 1 month of internship. This calls into question how much further learning occurs with physical examination throughout residency training.
authors.affiliation: Division of General Internal Medicine, Department of Medicine, University of Alabama at Birmingham, Huntsville Regional Medical Campus, Birmingham, Alabama 35294-0012, USA. lwillett@uabmc.edu
authors.forename: Lisa L
authors.initials: LL
authors.lastname: Willett
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Estrada
authors.forename: Analia
authors.initials: A
authors.lastname: Castiglioni
authors.forename: F Stanford
authors.initials: FS
authors.lastname: Massie
authors.forename: Gustavo R
authors.initials: GR
authors.lastname: Heudebert
authors.forename: May S
authors.initials: MS
authors.lastname: Jennings
authors.forename: Robert M
authors.initials: RM
authors.lastname: Centor
mesh_terms: D002983:Clinical Competence; D004503:Education, Medical, Graduate; D004521:Educational Measurement; D005260:Female; D006801:Humans; D007388:Internal Medicine / Q000193:education*; D007396:Internship and Residency; D008297:Male; D010808:Physical Examination