Journal of General Internal Medicine

, Volume 22, Issue 12, pp 1725–1730

Self-Confidence in and Perceived Utility of the Physical Examination: A Comparison of Medical Students, Residents, and Faculty Internists

  • Edward H. Wu
  • Mark J. Fagan
  • Steven E. Reinert
  • Joseph A. Diaz
Original Article

DOI: 10.1007/s11606-007-0409-8

Cite this article as:
Wu, E.H., Fagan, M.J., Reinert, S.E. et al. J GEN INTERN MED (2007) 22: 1725. doi:10.1007/s11606-007-0409-8



Little is known about the differences in attitudes of medical students, Internal Medicine residents, and faculty Internists toward the physical examination. We sought to investigate these groups’ self-confidence in and perceived utility of physical examination skills.


Cross-sectional survey of third- and fourth-year medical students, Internal Medicine residents, and faculty Internists at an academic teaching hospital.


Using a 5-point Likert-type scale, respondents indicated their self-confidence in overall physical examination skill, as well as their ability to perform 14 individual skills, and how useful they felt the overall physical examination, and each skill, to be for yielding clinically important information.


The response rate was 80% (302/376). The skills with overall mean self-confidence ratings less than “neutral” were interpreting a diastolic murmur (2.9), detecting a thyroid nodule (2.8), and the nondilated fundoscopic examination using an ophthalmoscope to assess retinal vasculature (2.5). No skills had a mean utility rating less than neutral. The skills with the greatest numerical differences between mean self-confidence and perceived utility were distinguishing between a mole and melanoma (1.5), detecting a thyroid nodule (1.4), and interpreting a diastolic murmur (1.3). Regarding overall self-confidence, third-year students’ ratings (3.3) were similar to those of first-year residents (3.4; p = .95) but less than those of fourth-year students (3.8; p = .002), upper-level residents (3.7; p = .01), and faculty Internists (3.9; p < .001).


Self-confidence in the physical exam does not necessarily increase at each stage of training. The differences found between self-confidence and perceived utility for a number of skills suggest important areas for educational interventions.


physical examination clinical skills medical education 

Copyright information

© Society of General Internal Medicine 2007

Authors and Affiliations

  • Edward H. Wu
    • 1
  • Mark J. Fagan
    • 1
  • Steven E. Reinert
    • 2
  • Joseph A. Diaz
    • 3
  1. 1.Division of General Internal Medicine, Rhode Island HospitalThe Warren Alpert Medical School of Brown UniversityProvidenceUSA
  2. 2.Lifespan RI Research Support ProgramProvidenceUSA
  3. 3.Division of General Internal Medicine, Memorial HospitalThe Warren Alpert Medical School of Brown UniversityPawtucketUSA

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