Learning abnormal physical examination signs: an introductory course.

Area of Science:

• Medical Education
• Osteopathic Medicine
• Clinical Skills Training

Background:

• Preclinical medical students, particularly in osteopathic programs, have limited exposure to abnormal physical examination (PE) findings.
• Early exposure to abnormal findings in simulation settings better prepares students for clinical encounters.

Purpose of the Study:

• To develop and implement an introductory course for first-year medical students (MS1s) focusing on abnormal PE signs and their pathophysiology.
• To address the educational gap in recognizing abnormal clinical findings for novice learners.

Main Methods:

• A 60-minute practical session involved students practicing and then demonstrating their ability to identify abnormal PE signs on a high-fidelity mannequin.
• Didactic sessions included lectures and PowerPoint presentations on relevant topics.
• Pre- and post-simulation evaluations assessed skill improvement and confidence; student satisfaction was also measured.

Main Results:

• Significant improvements were observed in five PE skills (p<0.0001), with average scores increasing from 63.1% to 88.74%.
• Student confidence in performing clinical skills and understanding pathophysiology significantly increased (p<0.0001), with average confidence scores rising from 3.3 to 4.5 on a 5-point scale.
• High learner satisfaction was reported, with a mean satisfaction score of 4.7 ± 0.4.

Conclusions:

• The introductory course effectively equipped MS1s with novice PE skills to learn various abnormal findings, including heart murmurs, lung sounds, and BP measurement.
• Abnormal PE findings were taught efficiently in terms of time and faculty resources.
• The course was well-received by MS1s, who provided positive feedback.