Perspective: moving students beyond an organ-based approach when teaching medical interviewing and physical examination skills.
Medical interviewing and physical examination skills are core pillars of clinical medicine. Though nearly all U.S. medical students participate in preclinical courses designed to teach these skills, medical school faculty often comment that students' abilities remain limited on entering their clinical clerkships. The reason for this contention is not clear.The author briefly describes the current preclinical curricula at most medical schools that are designed to teach patient interviewing and examination. An organ-based curriculum is commonly employed, although the limitations of such an approach readily become apparent. For example, many hospitalized patients do not suffer from single-organ illnesses, but rather from infections or metabolic derangements, which cause numerous abnormalities to several body systems. Furthermore, clinical reasoning skills are rarely taught in such preclinical courses, though these abilities form the foundation for effective doctoring. These findings suggest an opportunity for content development surrounding patient interviewing and examination. The author proposes an educational approach that depicts how the confluence of both content knowledge skills and clinical reasoning skills can work synergistically to enhance preclinical teaching of the medical interview and physical examination.
Alexander
Erik K
EK
Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts 02115, USA. ekalexander@partners.org
D000328:Adult; D002982:Clinical Clerkship / Q000379:methods* / Q000592:standards; D002983:Clinical Competence; D003479:Curriculum; D004504:Education, Medical, Undergraduate / Q000379:methods / Q000458:organization & administration; D005260:Female; D006801:Humans; D007388:Internal Medicine / Q000193:education*; D008297:Male; D008487:Medical History Taking / Q000379:methods* / Q000592:standards; D010808:Physical Examination / Q000379:methods* / Q000592:standards; D010817:Physician-Patient Relations; D018794:Problem-Based Learning / Q000379:methods; D013663:Teaching / Q000379:methods