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Related Concept Videos

Assessment of the Abdomen II: Percussion01:18

Assessment of the Abdomen II: Percussion

132
Percussion is a fundamental technique used to assess the liver, spleen, and abdominal organs by tapping the abdomen and interpreting the resulting sounds. This method helps identify fluid, distention, and masses through variations in sound, such as the high-pitched tympany of air-filled areas and the dullness of solid masses. Understanding how to percuss these organs provides valuable information for healthcare professionals in diagnosing conditions early.
Percussion
Percussion is an essential...
132

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A Consensus-Based Shoulder Examination for Rheumatology Training.

H Berk Degirmenci1, Robert Kalish2, Ratnesh Chopra3

  • 1Boston University Chobanian and Avedisian School of Medicine, Boston, Massachusetts.

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Rheumatology fellowship programs lack standardized shoulder exam training. This study surveyed program directors to establish consensus on essential shoulder examination maneuvers for fellows, aiming to improve teaching consistency.

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Area of Science:

  • Medical Education
  • Rheumatology
  • Musculoskeletal Examination

Background:

  • Shoulder examination is a non-standardized teaching objective in rheumatology fellowship programs.
  • Lack of consensus hinders consistent training for fellows in performing physical examinations for shoulder pain.

Purpose of the Study:

  • To investigate consensus among rheumatology fellowship program directors (PDs) regarding shoulder examination maneuvers for fellows.
  • To establish standardized teaching objectives for shoulder examinations in rheumatology training.

Main Methods:

  • Rheumatology PDs recorded themselves demonstrating a 5-minute shoulder examination.
  • Maneuvers were cataloged, and PDs ranked them via surveys (Tier 1, 2, or 3) to achieve ≥70% consensus.
  • A multi-round survey process refined consensus on examination techniques and tier designations.

Main Results:

  • 11 of 13 PDs participated, completing all study rounds.
  • Consensus was achieved for 40 out of 52 tier designation items and 8 out of 13 technique items.
  • The study identified key areas of agreement and disagreement in shoulder examination practices.

Conclusions:

  • This study provides the first consensus-based guidance on shoulder examinations specific to rheumatology practice.
  • The findings offer high-yield recommendations for standardizing rheumatology fellow training in shoulder assessment.
  • Establishing consensus improves the quality and consistency of physical examination skills taught to future rheumatologists.