Implementation of a Hypothesis-Driven Physical Exam Session in a Transition to Clerkship Program

Introduction The head-to-toe approach to teaching the physical examination (PE) focuses on technique and performing a comprehensive PE whereas core + clusters and hypothesis-driven PE (HDPE) approaches integrate clinical reasoning into performing a focused PE. These approaches can be implemented in...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Julia Kelly, Sandra K. Oza, Richard Feinn, Todd Cassese
Formato:	article
Lenguaje:	EN
Publicado:	Association of American Medical Colleges 2020
Materias:	Clinical Reasoning Physical Examination Hypothesis-Driven Physical Examination Clinical Skills Clinical Reasoning/Diagnostic Reasoning Clinical/Procedural Skills Training Medicine (General) R5-920 Education L
Acceso en línea:	https://doaj.org/article/0ea59bd1d4194bffbf3356d61114e0ec
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:0ea59bd1d4194bffbf3356d61114e0ec
record_format	dspace
spelling	oai:doaj.org-article:0ea59bd1d4194bffbf3356d61114e0ec2021-11-19T15:20:12ZImplementation of a Hypothesis-Driven Physical Exam Session in a Transition to Clerkship Program10.15766/mep_2374-8265.110432374-8265https://doaj.org/article/0ea59bd1d4194bffbf3356d61114e0ec2020-11-01T00:00:00Zhttp://www.mededportal.org/doi/10.15766/mep_2374-8265.11043https://doaj.org/toc/2374-8265Introduction The head-to-toe approach to teaching the physical examination (PE) focuses on technique and performing a comprehensive PE whereas core + clusters and hypothesis-driven PE (HDPE) approaches integrate clinical reasoning into performing a focused PE. These approaches can be implemented in a developmental sequence. We report the implementation and evaluation of an HDPE educational session. Methods We designed a 3-hour HDPE session as part of a transition to clerkship program. For each of five clinical vignettes, rising third-year students worked in pairs and then in small groups to generate a differential diagnosis and determine relevant PE maneuvers. Students next performed these maneuvers on peers with facilitator observation and feedback. Students completed postsession surveys on their retrospective pre- and postsession knowledge and confidence, as well as their satisfaction with the session. We completed quantitative and qualitative analyses on survey data. Results One hundred ninety-two students participated, and 140 (73%) completed the survey. Students were significantly more likely to report feeling confident generating a differential diagnosis and using it to select PE maneuvers for common complaints postsession. Over 80% of respondents felt the session improved critical thinking about patient presentations and would help them in clerkships. Discussion Our session increased student confidence in the progression to performing an HDPE just prior to the start of clerkships. The session is feasible and straightforward to implement. It requires a large number of faculty to facilitate, but the breadth of cases used allows inclusion of faculty from all fields.Julia KellySandra K. OzaRichard FeinnTodd CasseseAssociation of American Medical CollegesarticleClinical ReasoningPhysical ExaminationHypothesis-Driven Physical ExaminationClinical SkillsClinical Reasoning/Diagnostic ReasoningClinical/Procedural Skills TrainingMedicine (General)R5-920EducationLENMedEdPORTAL, Vol 16 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	Clinical Reasoning Physical Examination Hypothesis-Driven Physical Examination Clinical Skills Clinical Reasoning/Diagnostic Reasoning Clinical/Procedural Skills Training Medicine (General) R5-920 Education L
spellingShingle	Clinical Reasoning Physical Examination Hypothesis-Driven Physical Examination Clinical Skills Clinical Reasoning/Diagnostic Reasoning Clinical/Procedural Skills Training Medicine (General) R5-920 Education L Julia Kelly Sandra K. Oza Richard Feinn Todd Cassese Implementation of a Hypothesis-Driven Physical Exam Session in a Transition to Clerkship Program
description	Introduction The head-to-toe approach to teaching the physical examination (PE) focuses on technique and performing a comprehensive PE whereas core + clusters and hypothesis-driven PE (HDPE) approaches integrate clinical reasoning into performing a focused PE. These approaches can be implemented in a developmental sequence. We report the implementation and evaluation of an HDPE educational session. Methods We designed a 3-hour HDPE session as part of a transition to clerkship program. For each of five clinical vignettes, rising third-year students worked in pairs and then in small groups to generate a differential diagnosis and determine relevant PE maneuvers. Students next performed these maneuvers on peers with facilitator observation and feedback. Students completed postsession surveys on their retrospective pre- and postsession knowledge and confidence, as well as their satisfaction with the session. We completed quantitative and qualitative analyses on survey data. Results One hundred ninety-two students participated, and 140 (73%) completed the survey. Students were significantly more likely to report feeling confident generating a differential diagnosis and using it to select PE maneuvers for common complaints postsession. Over 80% of respondents felt the session improved critical thinking about patient presentations and would help them in clerkships. Discussion Our session increased student confidence in the progression to performing an HDPE just prior to the start of clerkships. The session is feasible and straightforward to implement. It requires a large number of faculty to facilitate, but the breadth of cases used allows inclusion of faculty from all fields.
format	article
author	Julia Kelly Sandra K. Oza Richard Feinn Todd Cassese
author_facet	Julia Kelly Sandra K. Oza Richard Feinn Todd Cassese
author_sort	Julia Kelly
title	Implementation of a Hypothesis-Driven Physical Exam Session in a Transition to Clerkship Program
title_short	Implementation of a Hypothesis-Driven Physical Exam Session in a Transition to Clerkship Program
title_full	Implementation of a Hypothesis-Driven Physical Exam Session in a Transition to Clerkship Program
title_fullStr	Implementation of a Hypothesis-Driven Physical Exam Session in a Transition to Clerkship Program
title_full_unstemmed	Implementation of a Hypothesis-Driven Physical Exam Session in a Transition to Clerkship Program
title_sort	implementation of a hypothesis-driven physical exam session in a transition to clerkship program
publisher	Association of American Medical Colleges
publishDate	2020
url	https://doaj.org/article/0ea59bd1d4194bffbf3356d61114e0ec
work_keys_str_mv	AT juliakelly implementationofahypothesisdrivenphysicalexamsessioninatransitiontoclerkshipprogram AT sandrakoza implementationofahypothesisdrivenphysicalexamsessioninatransitiontoclerkshipprogram AT richardfeinn implementationofahypothesisdrivenphysicalexamsessioninatransitiontoclerkshipprogram AT toddcassese implementationofahypothesisdrivenphysicalexamsessioninatransitiontoclerkshipprogram
_version_	1718419995585675264

Implementation of a Hypothesis-Driven Physical Exam Session in a Transition to Clerkship Program

Ejemplares similares