Abstract
Unlike patient interviewing skills, physical examination (PE) has always been a part of undergraduate medical education and, unlike teaching of communication skills, teaching PE has mostly remained unchanged. From the mid-1950s to the 2010s, textbooks of PE have presented an unselective compilation of physical signs regardless of their clinical importance.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Kampmeier RH. Physical examination in health and disease. 2nd ed. Philadelphia: FA Davis Co; 1957.
Bickley LS, Szilagyi PG. Bates’ guide to physical examination and history taking. 11th ed. Philadelphia: Lippincott Williams & Wilkins; 2013.
Uchida T, Farnan JM, Schwartz JE, Heiman HL. Teaching the physical examination: a longitudinal strategy for tomorrow’s physicians. Acad Med. 2014;89:373–5.
Alexander EK. Perspective: moving students beyond an organ-based approach when teaching medical interviewing and physical examination skills. Acad Med. 2008;83:906–9.
Wray NP, Friedland JA. Detection and correction of house staff error in physical diagnosis. JAMA. 1983;249:1035–7.
Johnson JE, Carpenter JL. Medical house staff performance in physical examination. Arch Intern Med. 1986;146:937–41.
Reilly BM. Physical examination in the care of medical inpatients: an observational study. Lancet. 2003;362:1100–5.
Singh H, Giardina TD, Meyer AND, Forjuoh SN, Reis MD, Thomas EJ. Types and origins of diagnostic errors in primary care settings. JAMA. 2013;173:418–25.
Peitzman SJ, Cuddy MM. Performance in physical examination on the USMLE Step 2 clinical skills examination. Acad Med. 2014. doi:10.1097/ACM.0000000000000570.
Cook CJ, Smith GB. Do textbooks of clinical examination contain information regarding the assessment of critically ill patients? Resuscitation. 2004;60:129–36.
Joshua AM, Celermajer DS, Stockler MR. Beauty is in the eye of the examiner: reaching agreement about physical signs and their value. Intern Med J. 2005;35:178–87.
Kugler J, Verghese A. The physical exam and other forms of fiction. J Gen Intern Med. 2010;25:756–7.
Auld AG. The roentgen rays in the diagnosis of pulmonary disease. Lancet. 1903;162:341–2.
Todd IK. A thorough pulmonary exam and other myths. Acad Med. 2000;75:50–1.
Sackett DL, Rennie D. The science of the art of the clinical examination. JAMA. 1992;267:2650–2.
Metlay JP, Kapoor WN, Fine MJ. Does this patient have community-acquired pneumonia? Diagnosing pneumonia by history and physical examination. JAMA. 1997;278:1440–5.
McGee S. Evidence based physical diagnosis. 2nd ed. Philadelphia: WB Saunders Co; 2007.
Elliot DL, Hickam DH. Evaluation of physical examination skills. Reliability of faculty observers and patient instructors. JAMA. 1987;258:3405–8.
Noel GL, Herbers JE Jr, Caplow MP, Cooper GS, Pangaro LN, Harvey J. How well do internal medicine faculty members evaluate the clinical skills of residents? Ann Intern Med. 1992;117:757–65.
Mangione S, Nieman LZ, Gracely E, Kaye D. The teaching and practice of cardiac auscultation during internal medicine and cardiology training. A nationwide survey. Ann Intern Med. 1993;119:47–54.
Verghese A, Horwitz RI. In praise of the physical examination. BMJ. 2009;339:b5448.
Benbassat J, Polak BCP, Javitt JC. Objectives of teaching direct ophthalmoscopy to medical students. Acta Ophthalmol. 2012;90:503–7.
Bruce BB, Lamirel CC, Wright DW, Ward A, Heilpern KL, Biousse V, Newman NJ. Nonmydriatic ocular fundus photography in the emergency department. N Engl J Med. 2011;364:387–8.
Mower W, Sachs C, Nicklin E, Baraff LJ. Pulse oximetry as a fifth vital sign. Pediatrics. 1997;99:681–6.
Wiener S, Nathanson M. Physical examination. Frequently observed errors. JAMA. 1976;236:852–5.
Metlay JP, Fine MJ. Testing strategies in the initial management of patients with community-acquired pneumonia. Ann Intern Med. 2003;138:109–18.
Heckerling PS, Tape TG, Wigton RS, Hissong KK. Leikin JB, Ornato JP, Cameron JL, Racht EM. Clinical prediction rule for pulmonary infiltrates. Ann Intern Med. 1990;113:664–70.
Lee KC, Dunlop D, Dolan NC. Do clinical breast examination skills improve during medical school? Acad Med. 1998;73:1013–9.
Diehr P, Wood RW, Bushyhead J, Krueger L, Wolcott B, Tompkins RK. Prediction of pneumonia in outpatients with acute cough—a statistical approach. J Chronic Dis. 1984;37:215–25.
Gennis P, Gallagher J, Falvo C, Baker S, Than W. Clinical criteria for the detection of pneumonia in adults: guidelines for ordering chest roentgenograms in the emergency department. J Emerg Med. 1989;7:263–8.
Nolt BR, Gonzales R, Maselli J, Aagaard E, Camargo CA, Metlay JP. Vital-sign abnormalities as predictors of pneumonia in adults with acute cough illness. Am J Emerg Med. 2007;25:631–6.
Kalantri S, Joshi R, Lokhande T, Singh A, Morgan M, Colford JM, Pai M. Accuracy and reliability of physical signs in the diagnosis of pleural effusion. Respir Med. 2007;101:431–8.
Smith SR, Dollase RH, Boss JA. Assessing students’ performances in a competency-based curriculum. Acad Med. 2003;78:97–107.
Learning objectives for medical student education–guidelines for medical schools: report I of the Medical School Objectives Project. Acad Med. 1999;74:13–8.
Bradding P, Cookson JB. The dos and don’ts of examining the respiratory system: a survey of British Thoracic Society members. J R Soc Med. 1999;92:632–4.
Mulrow CD, Dolmatch BL, Delong ER, Feussner JR, Benyunes MC, Dietz JL, Lucas SK, Pisano ED, Svetkey LP, Volpp BD, et al. Observer variability in the pulmonary examination. J Gen Intern Med. 1986;1:364–7.
Mangione S, Nieman LZ. Pulmonary auscultatory skills during training in internal medicine and family practice. Am J Respir Crit Care Med. 1999;159:1119–24.
Gabbay J, leMay A. Evidence based guidelines or collectively constructed “mindlines” ethnographic study of knowledge management in primary care. BMJ. 2004;329(7473):1013.
Choudhry NK, Fletcher RH, Soumerai SB. Systematic review: the relationship between clinical experience and quality of health care. Ann Intern Med. 2005;142:260–73.
Stillman PL, May JR, Meyer DM, Rutala PJ, Veach TL, Montgomery AB. A collaborative effort to study methods of teaching physical examination skills. J Med Educ. 1981;56:301–6.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
Copyright information
© 2015 Springer International Publishing Switzerland
About this chapter
Cite this chapter
Benbassat, J. (2015). Physical Examination Skills: Learning Difficulties. In: Teaching Professional Attitudes and Basic Clinical Skills to Medical Students. Springer, Cham. https://doi.org/10.1007/978-3-319-20089-7_9
Download citation
DOI: https://doi.org/10.1007/978-3-319-20089-7_9
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-20088-0
Online ISBN: 978-3-319-20089-7
eBook Packages: MedicineMedicine (R0)