Teaching foundational physical examination skills: Study results comparing lay teaching associates and physician instructors
ABSTRACT The purpose of this pilot study was to determine differences in the physical exam skills of first-year medical students learning physical exam exclusively from standardized physical examination teaching associates (SPETAs) or physician faculty.
In all, 144 first-year medical students were randomized to receive SPETA or physician-led physical examination instruction. Students participated in an OSCE assessment immediately following the end of the curriculum block.
SPETA-trained students performed equivalently to physician faculty trained students across all stations with a mean of 82.9% versus 81.2% (p = .226). Students taught by SPETAs performed significantly better on the abdominal OSCE with a mean score of 88.8%, while physician faculty taught students had a mean score of 85.4% (p = .03).
Findings from this study suggest that SPETAs can effectively teach foundational physical examination skills to medical students at a similar and sometimes better performance level as physician faculty.
- SourceAvailable from: Anna Oswald
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- "Patient educators have been successful in teaching many aspects of general and system specific physical examination [28-34]. The Pelvic Exam Program is a patient educator initiative that has improved male and female genital examination clinical skills teaching [35-39]. "
ABSTRACT: Despite the high burden of musculoskeletal (MSK) diseases, few generalists are comfortable teaching MSK physical examination (PE) skills. Patient Partners® in Arthritis (PP®IA) is a standardized patient educator program that could potentially supplement current MSK PE teaching. This study aims to determine if differences exist in MSK PE skills between non-MSK specialist physician and PP®IA taught students. Pre-clerkship medical students attended 2-hour small group MSK PE teaching by either non-MSK specialist physician tutors or by PP®IA. All students underwent an MSK OSCE and completed retrospective pre-post questionnaires regarding comfort with MSK PE and interest in MSK. 83 students completed the OSCE (42 PP®IA, 41 physician taught) and 82 completed the questionnaire (42 PP®IA, 40 physician taught). There were no significant differences between groups in OSCE scores. For all questionnaire items, post-session ratings were significantly higher than pre-session ratings for both groups. In exploratory analysis PP®IA students showed significantly greater improvement in 12 of 22 questions including three of five patient-centred learning questions. PP®IA MSK PE teaching is as good as non-MSK specialist physician tutor teaching when measured by a five station OSCE and provide an excellent complementary resource to address current deficits in MSK PE teaching.BMC Medical Education 09/2011; 11:65. DOI:10.1186/1472-6920-11-65 · 1.41 Impact Factor
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ABSTRACT: Background: Urethral catheterization is a commonly performed procedure. Therefore medical students should receive adequate training in this technique to avoid devastating consequences of performing it poorly. This study was aimed at finding out the knowledge and experience of final year medical students with the technique of male urethral catheterization. Methods: Well-structured questionnaire was administered to each of the final year medical students of Ladoke Akintola University of Technology (LAUTECH) one week to their final examinations. Results: All the 215 students received the questionnaire one week before their final examinations with 128 (60%) completing it. The male to female ratio was 1:1 with a mean age of 28 years. One hundred and twenty-five (98.4%) of the students had been throught male urethral catheterization. Thirty-five (27.6%) of the students have never performed male urethral catheterization. One hundred and fifteen students (90.6%) agreed that urethral catheterization is a sterile procedure. Sixty-nine (54.3%) students said xylocaine jelly should be used as lubricant.. Ninety four (74%) students said that they will inflate the balloon of the catheter when the Y-junction gets to the tip of the penis. Forty-nine (38.6%) students said they are very confident about male urethral catheterization, 61 (48.0%) said reasonably confident while 5 (3.9%) are not confident at all. Conclusions: Urethral catheterization is a common procedure. Students should receive adequate instruction in this technique to avoid devastating consequences of performing it poorly.
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ABSTRACT: Poor performance on a medical school comprehensive clinical skills assessment after core clerkships requires remediation. Little is known about techniques used to remedy students' skills deficits and their effectiveness. The authors identified remediation strategies used at U.S. medical schools and determined instructors' confidence in remediation. In the fall of 2007, the authors surveyed persons responsible for remediation at U.S. medical schools that conduct comprehensive clinical assessments and remediation. Respondents reported their use of four types of remediation strategies: (1) clinical activities, (2) independent study, (3) precepted video review of exam recording, and (4) organized group activities for deficits in history-taking, physical examination, knowledge, clinical reasoning, professionalism, and communication. The authors assessed confidence in remediation for the six skill areas and analyzed these measures using repeated-measures analysis of variance. Fifty-three of 71 (74.6%) participants responded. Educators most commonly employ the precepted video review remediation activity across the six skill areas, and they use the clinical activities least commonly. Confidence in remediating the six skill areas was below the "agree" level. Confidence was highest for remediating history-taking and physical examination problems and lowest for professionalism. Educators express modest confidence in remediating fourth-year students' clinical skills deficiencies. The finding that schools employ primarily video review for remediation suggests a potential need to augment opportunities for mentored skills practice to address deficits more effectively. The remediation literature similarly stresses the importance of multiple approaches tailored to particular deficits.Academic medicine: journal of the Association of American Medical Colleges 06/2009; 84(5):669-76. DOI:10.1097/ACM.0b013e31819fa832 · 3.47 Impact Factor