scholarly journals Expanding OSCE-related Learning Opportunities For Pre-Clerkship Students: Insights From an Assessment for Learning Curriculum

2020 ◽  
Vol 7 ◽  
pp. 238212052094066
Author(s):  
Aaron W Bernard ◽  
Listy Thomas ◽  
Jennifer Rockfeld ◽  
Todd Cassese
Keyword(s):  
Physical Examination ◽  
Clinical Skills ◽  
Assessment For Learning ◽  
Learning Opportunities ◽  
Lessons Learned ◽  
Clinical Question ◽  
History Taking ◽  
Question Generation ◽  
Objective Structured Clinical Examinations ◽  
Oral Presentations

Pre-clerkship clinical skills courses at many medical schools use objective structured clinical examinations (OSCEs) to assess students’ development as it relates to the foundational clinical skills of history taking, communication, and physical examination. The authors report on a curriculum in which OSCEs also serve as a springboard for additional learning by linking them to activities that include patient write-ups, oral presentations, clinical reasoning discussions, clinical question generation, and video review with faculty. The rationale for using OSCEs as an assessment for learning tool is discussed, and some lessons learned are reported.

scholarly journals A Multivariate Generalizability Analysis of History-Taking and Physical Examination Scores From the USMLE Step 2 Clinical Skills Examination

2009 ◽  
Vol 84 (Supplement) ◽  
pp. S86-S89 ◽  
Author(s):  
Brian E. Clauser ◽  
Kevin Balog ◽  
Polina Harik ◽  
Janet Mee ◽  
Nilufer Kahraman
Keyword(s):  
Physical Examination ◽  
Clinical Skills ◽  
History Taking ◽  
Usmle Step ◽  
Generalizability Analysis

scholarly journals Virtual Integrated Patient: An AI supplementary tool for second-year medical students

2021 ◽  
Vol 6 (3) ◽  
pp. 87-90
Author(s):  
Juanita S. M. Kong ◽  
Boon See Teo ◽  
Yueh Jia Lee ◽  
Anu Bharath Pabba ◽  
Edmund J.D. Lee ◽  
...  
Keyword(s):  
Medical Students ◽  
Pilot Study ◽  
Physical Examination ◽  
Clinical Skills ◽  
History Taking ◽  
Clinical Rotations ◽  
Face To Face ◽  
Second Year ◽  
Standardised Patients ◽  
Real Patients

Introduction: With the COVID-19 pandemic, Singapore underwent a national lockdown in which most organisations, including schools were closed. Halting face-to-face tutorials resulting in decreased clinical contact for medical students. Prior to the pandemic, we had developed the Virtual Integrated Patient (VIP). Equipped with conversational technology, it provides students online practice in various clinical skills such as history-taking, physical examination and investigations. The aim of this paper is to describe the supplementary use of VIP in the second-year class, in which a pilot study was conducted. Methods: The VIP platform was introduced to the cohort and used to supplement the teaching of history-taking in the “Communication with Patients” (CWP) module for second-year students. Traditionally, CWP tutorials involve face-to-face history-taking from standardised patients (SPs). Students, who consented to participating in the trial, had an additional 3 weeks’ access to VIP to practice their history-taking skills. They completed a survey on their user experience and satisfaction at the end of the 3 weeks. Results: Out of the 106 participants, 87% strongly agreed or agreed that using VIP helped in remembering the content while 69% of them felt that VIP increased their confidence and competence in history-taking. Conclusion: VIP was well-received by students and showed promise as a tool to supplement history-taking tutorials, prior to students’ encounter with SPs and real patients. Hence, this trend showed its potential as an alternative when clinical rotations were delayed or cancelled. Further research can be done to evaluate its effectiveness in this context.

scholarly journals Assessment of the performance of orthopaedic residents in clinical practice

2019 ◽  
Author(s):  
Bruno Machado Silva ◽  
Marcos Rassi ◽  
Edna Pereira
Keyword(s):  
Clinical Practice ◽  
Physical Examination ◽  
Formative Assessment ◽  
Clinical Evaluation ◽  
Clinical Skills ◽  
Assessment Method ◽  
Counseling Skills ◽  
History Taking ◽  
Evaluation Exercise ◽  
The Mean

Abstract Objective Mini-Clinical Evaluation Exercise (Mini-CEX) is a strategy for performing and documenting direct observation and formative assessment of clinical skills. This assessment method promotes identify deficiencies in history taking, physical examination and counseling skills. Furthermore, Mini-CEX is easy to implement and less cost. Thus, our objective was to evaluate the performance of orthopaedic residents in while conducting clinical examinations. Methods Mini-CEX was applied by three faculties in four different moments. The instrument was adapted by the authors for use in orthopaedics, with the development of descriptors for each evaluated skill. Supervisors were trained to use the Mini-CEX by the principal investigator through teaching materials and discussions, with standardization of the instrument descriptors. Results The mean scores obtained in the 4 evaluations for each of the 21 residents reveal improvement in the performances of residents in all skills assessed from the first to the fourth meeting. Conclusions We have found that the performance of orthopaedic residents presented a satisfactory evolution, with progressive improvement in all skills.

scholarly journals Parent assessment of medical student skills in ambulatory pediatrics

2013 ◽  
Vol 4 (2) ◽  
pp. e18-e27
Author(s):  
Erika Persson ◽  
Christina Haines ◽  
Mia Lang
Keyword(s):  
Medical Student ◽  
Physical Examination ◽  
Student Involvement ◽  
Clinical Skills ◽  
Student Assessment ◽  
Secondary Outcome ◽  
History Taking ◽  
Parent Attitudes ◽  
Communication History ◽  
Parent Assessment

Background: Partnership with parents is a vital part of pediatric medical education, yet few studies have examined parent attitudes towards learners in pediatric settings. Methods: Questionnaires were used to determine parent and student assessment of professional and clinical skills (primary outcome) and parent attitudes towards 3rd year medical students (secondary outcome) at the University of Alberta. Chi Square, Kendall’s Tau and Kappa coefficients were calculated to compare parent and student responses in 8 areas: communication, respect, knowledge, listening, history taking, physical examination, supervision, and overall satisfaction. Results: Overall satisfaction with medical student involvement by parents was high: 56.7% of all parents ranked the encounter as ‘excellent’. Areas of lesser satisfaction included physician supervision of students. Compared to the parent assessment, students tended to underrate many of their skills, including communication, history taking and physical exam. There was no relationship between parent demographics and their attitude to rating any of the students’ skills. Conclusions: Parents were satisfied with medical student involvement in the care of their children. Areas identified for improvement included increased supervision of students in both history taking and physical examination. This is one of the largest studies examining parent attitudes towards pediatric students. The results may enhance undergraduate curriculum development and teaching in pediatric ambulatory clinics and strengthen the ongoing partnership between the community and teaching clinics.

History taking and physical examination

2017 ◽  
pp. 153-158
Author(s):  
José M. Ribera-Casado
Keyword(s):  
Physical Examination ◽  
Older Patients ◽  
Clinical Skills ◽  
Geriatric Medicine ◽  
Social Situation ◽  
History Taking ◽  
Medication History ◽  
Younger Patients ◽  
Medicine History ◽  
Clinical Conditions

In geriatric medicine, history taking and physical examination differ from the way that these clinical skills are traditionally recommended for younger patients. The definitive approach to a full diagnostic appraisal is through a ‘comprehensive geriatric assessment’. This takes time, and may need modification of the use of language and of the physical setting. Social situation, physical and mental function, and bioethical personal values are essential components of this approach. The findings from a careful, systematic, and detailed physical examination can never be replaced by biological or clinical tests. Physical findings typical for some clinical conditions in younger patients may be absent in older patients and some significant findings are particular to older patients. Certain aspects of assessment tend to be more commonly overlooked, including full medication history including self-medicating habits, nutritional status, and evidence suggesting physical, sexual, or mental abuse.

scholarly journals Evaluation of a Preclerkship Learning Community Model for Delivering Clinical Skills Curriculum

2019 ◽  
Vol 6 ◽  
pp. 238212051985506
Author(s):  
Danielle Roussel ◽  
Katherine Anderson ◽  
Tiffany Glasgow ◽  
Jorie M Colbert-Getz
Keyword(s):  
Physical Examination ◽  
Learning Community ◽  
Student Performance ◽  
Clinical Skills ◽  
Evaluation Framework ◽  
Performance Improvements ◽  
Community Model ◽  
Objective Structured Clinical Examinations ◽  
Curriculum Delivery ◽  
Performance Domains

Background: Medical schools are increasingly using learning communities (LCs) for clinical skills curriculum delivery despite little research on LCs employed for this purpose. We evaluated an LC model compared with a non-LC model for preclerkship clinical skills curriculum using Kirkpatrick’s hierarchy as an evaluation framework. Methods: The first LC cohort’s (N = 101; matriculating Fall 2013) reaction to the LC model was assessed with self-reported surveys. Change in skills and learning transfer to clerkships was measured with objective structured clinical examinations (OSCEs) at the end of years 2 and 3 and first and last clerkship preceptor evaluations; the LC cohort and the prior cohort (N = 86; matriculating Fall 2012) that received clinical skills instruction in a non-LC format were compared with Mann-Whitney U tests. Results: The LC model for preclerkship clinical skills curriculum was rated as excellent or good by 96% of respondents in Semesters 1 to 3 (N = 95). Across multiple performance domains, 96% to 99% of students were satisfied to very satisfied with their LC faculty preceptors (N varied by item). For the end of preclerkship OSCE, the LC cohort scored higher than the non-LC cohort in history gathering ( P = .003, d = 0.50), physical examination ( P = .019, d = 0.32), and encounter documentation ( P ⩽ .001, d = 0.47); the non-LC cohort scored higher than the LC cohort in communication ( P = .001, d = 0.43). For the end of year 3 OSCE, the LC cohort scored higher than the non-LC cohort in history gathering ( P = .006, d = 0.50) and encounter note documentation ( P = .027, d = 0.24); there was no difference in physical examination or communication scores between cohorts. There was no detectable difference between LC and non-LC student performance on the preceptor evaluation forms at either the beginning or end of the clerkship curriculum. Conclusions: We observed limited performance improvements for LC compared with non-LC students on the end of the preclerkship OSCE but not on the clerkship preceptor evaluations. Additional studies of LC models for clinical skills curriculum delivery are needed to further elucidate their impact on the professional development of medical students.

Using Objective Structured Clinical Examinations to Assess Intern Orthopaedic Physical Examination Skills: A Multimodal Didactic Comparison

2017 ◽  
Vol 74 (3) ◽  
pp. 513-518 ◽  
Author(s):  
Donna Phillips ◽  
Christian A. Pean ◽  
Kathleen Allen ◽  
Joseph Zuckerman ◽  
Kenneth Egol
Keyword(s):  
Physical Examination ◽  
Objective Structured Clinical Examinations

scholarly journals Intestinal Obstruction following Ingestion of Metallic Instruments in a Psychiatric Patient

2018 ◽  
Vol 2018 ◽  
pp. 1-3 ◽  
Author(s):  
Oscar Kivike ◽  
Israel Soko ◽  
David Mgaya ◽  
Frank Sandi
Keyword(s):  
Physical Examination ◽  
Intestinal Obstruction ◽  
Female Patient ◽  
Psychiatric Patient ◽  
Psychiatric Patients ◽  
Abdominal Distension ◽  
History Taking ◽  
Proximal Intestine ◽  
Psychotic Features

Pica among psychiatric patients has been well documented. We report a 25-year-old female patient who presented with abdominal distension for one week. She is a known psychiatric patient for 5 years. Through history taking, physical examination, and investigations, the patient was found to have psychotic features and features of intestinal obstruction. Surgery was done by opening the abdomen and then the stomach. The stomach, together with the proximal intestine, was found to be filled with metallic instruments weighing 780 mg. The diagnosis of a metalophagia type of pica was reached. All instruments were removed and the patient did well postoperatively.

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