Does residency training improve performance of physical examination skills?

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.

To determine differences between postgraduate year (PGY)-1 and PGY-3 residents on performance and comfort of physical examination skills.

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.

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).

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.