Relationship of Physical Examination Technique to Associated Clinical Skills: Results from a Direct Observation Assessment

Author(s):  
Bennett W. Clark ◽  
Timothy Niessen ◽  
Ariella Apfel ◽  
Joyce Luckin ◽  
Yi Zhen Joan Lee ◽  
...  
JAMA ◽  
2009 ◽  
Vol 302 (12) ◽  
pp. 1316 ◽  
Author(s):  
Jennifer R. Kogan ◽  
Eric S. Holmboe ◽  
Karen E. Hauer

Author(s):  
José Antonio Rodríguez Montes

Currently there is a consensus that the clinical art have been greatly deteriorating during the past 50 years. This problem has raised worldwide attention through as increase in publications, courses, symposia and congress. The erosion of bedside teaching and the consequent decline of clinical skills, notably wrongfull and inadequate use of new technologies. At as result, it becomes difficult if not impossible obtain an appropiate collection of the synptoms sufferick for the sick. Together with the medical history, the physical examination is mandatory for the correct diagnosis and developing the treatment plan. In this paper, the decline of clinical art is exposed and how this ancient heritage of medical practice can be recovered.


2021 ◽  
Vol 6 (2) ◽  
pp. 57-60
Author(s):  
Yoshinobu Shoji

Toothaches typically originate from the odontogenic structures such as dentin, pulp and periodontium. Toothaches which have an odontogenic origin are managed effectively in the dental clinic; however, toothaches with a nonodontogenic origin are often difficult to identify. This article presents a case of trigeminal neuralgia that was misdiagnosed as pain of odontogenic origin and initially treated surgically and endodontically, despite no abnormality detected in the physical examination or X-ray. The aim of this article is to present a case of trigeminal neuralgia that may mimic odontogenic toothache. This case highlights the importance of having thorough knowledge and the appropriate clinical skills to differentiate both odontogenic and nonodontogenic toothaches, as well as the need for careful diagnosis before undertaking any treatment.


Author(s):  
Julia Kardin ◽  
Dasrul Dasrul ◽  
Sugito Sugito ◽  
Nurliana Nurliana ◽  
Teuku Zahrial Helmi

The purpose of this research was to identify the relationship of characteristic and knowledge of farmers to the successful of artificial insemination (AI) in Aceh Besar Districts. The number of respondents is 93 people from twenty three districts in Aceh Besar, selected purposively as the sample of this research. The instruments used in this research are questionnaire and direct observation in the field, while the observed variables are: farmer characteristics, farmer knowledge and artificial insemination result. The results of this research revealed that the characteristics and knowledge of the farmers were good and showed a real relationship to the successfulness of AI in Aceh Besar Districts. The average service per conception (S / C) in Aceh Besar Districts during 2017 was 1.32 while the conception rate (CR) was 86.36%. The results were in accordance with the standard of general guidance of Upsus Siwab Year 2017.


MedEdPublish ◽  
2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Pamela Basehore ◽  
Shiyuan Wang ◽  
Mehwish Khan

2019 ◽  
Vol 5 (2-3) ◽  
pp. 78-81
Author(s):  
Dale Berg ◽  
Katherine Berg

BackgroundSimulation hybrids combine single modality simulation such as simulated patients (SP) with low-fidelity simulation to create a potentially more powerful set of educational tools. To make a hybrid that is credible, standardised and inexpensive remains a challenge. We describe the development of the simulation vest (S-Vest), an inexpensive, standardised teaching tool that is ‘worn’ by an SP to form a hybrid.MethodsWe have created a vest which contains a set of speakers placed in an anatomical manner and produce sounds. The sounds played from a multitrack audio player are recorded in vivo from a patient with the real disease findings. The SP provides history while the vest provides the objective palpable and auscultatory findings. The speakers are placed in the routine standardised locations taught in physical examination.ResultsWe have developed several case scenarios designed for the vest. One of these cases is an elderly patient with aortic stenosis. The aortic stenosis case audio file has four unique tracks recorded over the precordium. Each track is played at the speaker appropriate to the physical exam findings. The SP plays an elderly man with chest pain. The vest provides the sounds of a loud systolic murmur with marked diminishment of S2 and a palpable thrill.ConclusionsThe S-Vest is a low-fidelity, low-cost simulator to use in hybrid and simulation. The S-Vest can be used in a formative and summative Objective Structured Clinical Examination (OSCE) station and in skills attainment for learners in healthcare. We believe these tools will be of significant import to teaching clinical skills.


2007 ◽  
Vol 36 (7) ◽  
pp. 661-668 ◽  
Author(s):  
CHAD M. DEVITT ◽  
MARLON R. NEELY ◽  
BRIAN J. VANVECHTEN

2012 ◽  
Vol 4 (4) ◽  
pp. 521-524 ◽  
Author(s):  
Michael FitzGerald ◽  
Mia Mallory ◽  
Matthew Mittiga ◽  
Charles Schubert ◽  
Hamilton Schwartz ◽  
...  

Abstract Background The importance and benefits of direct observation in residency training have been underscored by a number of studies. Yet, implementing direct observation in an effective and sustainable way is hampered by demands on physicians' time and shrinking resources for educational innovation. Objective To describe the development and pilot implementation of a direct observation tool to assess the history and physical examination skills of interns in a pediatric emergency department rotation. Methods A task force developed specific history and physical examination checklists for a range of common conditions. For the pilot implementation, 10 pediatric emergency medicine faculty attendings conducted the initial observations of 34 interns during the course of 1 academic year. At the conclusion of the pilot, the faculty observers and interns were interviewed to assess the feasibility and benefits of the process. Results A total of 33 of the 34 interns were observed during their rotation, with 26 of the observations conducted when the faculty observer was off shift, and it took approximately 20 minutes to complete each observation. In terms of learning benefits, interns and faculty observers reported that it facilitated clear and useful feedback and revealed gaps that would not have otherwise been identified. Faculty observers also mentioned that it helped them focus their teaching effort, built empathy with learners, and gave them a way to demonstrate a true concern for their learning. Conclusion Our results offer evidence for the feasibility and benefits of the direct observation checklists. The description of the implementation, challenges, and response to those challenges may help others avoid some of the common problems faced when implementing direct observation methods.


2016 ◽  
Vol 129 (24) ◽  
pp. 3004-3006
Author(s):  
Yi-Xin Zhou ◽  
De-Jin Yang ◽  
Hong-Yi Shao

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