The use of instructor-patients to teach physical examination techniques

The increasing difficulty in obtaining appropriate hospitalized patients to give enlarging classes of medical students their first exposure to abnormal physical findings has led to the development of an instructor-patient program. Sixteen community residents with relatively stable respiratory, cardiovascular, musculoskeletal, or neurological findings were recruited and trained as instructor-patients to teach the technical elements of the examination of the affected organ system. Evaluation of the technical skills of 46 second-year students trained by instructor-patients and those of 41 randomly selected students trained in these skills by physician instructors demonstrated that the two have comparable technical skills five to eight weeks after the training sessions. Faculty recruitment, instructor-patient recruitment and training, and evaluation are discussed.