Resources Used to Teach the Physical Exam to Preclerkship Medical Students: Results of a National Survey

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Abstract

Purpose

To examine resources used in teaching the physical exam to preclerkship students at U.S. medical schools.

Method

The Directors of Clinical Skills Courses developed a 49-question survey addressing resources and pedagogical methods employed in preclerkship physical exam curricula. The survey was sent to all 141 Liaison Committee on Medical Education–accredited medical schools in October 2015. Results were averaged across schools, and data were weighted by class size.

Results

Results from 106 medical schools (75% response rate) identified a median of 59 hours devoted to teaching the physical exam. Thirty-eight percent of time spent teaching the physical exam involved the use of standardized patients, 30% used peer-to-peer practice, and 25% involved examining actual patients. Approximately half of practice time with actual patients was observed by faculty. At 48% of schools (51), less than 15% of practice time was with actual patients, and at 20% of schools (21) faculty never observed students practicing with actual patients. Forty-eight percent of schools (51) did not provide compensation for their outpatient clinical preceptors.

Conclusions

There is wide variation in the resources used to teach the physical examination to preclerkship medical students. At some schools, the amount of faculty observation of students examining actual patients may not be enough for students to achieve competency. A significant percentage of faculty teaching the physical exam remain uncompensated for their effort. Improving faculty compensation and increasing use of senior students as teachers might allow for greater observation and feedback and improved physical exam skills among students.

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