Assessing the head-to-toe physical examination skills of medical students

Medical Teacher
Rachel YudkowskyMihaela Popa

Abstract

Second-year medical students performed a head-to-toe screening physical examination on trained patient instructors (PIs) as a high-stakes examination before beginning clinical clerkships. PIs completed a 138-item checklist and instructed the students in the proper performance of any incorrectly executed or omitted items. To assess the accuracy of the PI ratings, 'monitor' PIs watching the encounter by video completed checklists for 11 retests of failed students in 2001 and for 28 randomly selected encounters in 2002. Checklist-level discrepancies measured by mean absolute checklist difference were 8% in 2001 and 9% in 2002. Case-level mean difference between raters in 2002 was -2.9%. The inter-rater reliability for a single rater, estimated by the intra-class correlation coefficient for total encounter scores, was 0.95. The assessment and feedback were well received by the students. The Head-to-Toe examination provides a reliable assessment of a student's ability to carry out a complete screening physical examination. Patient instructors can be trained to acceptable accuracy and reliability despite the length and complexity of the exercise, and can provide effective feedback and teaching targeted to individual student deficienc...Continue Reading

References

Mar 26, 2003·Advances in Health Sciences Education : Theory and Practice·John R BouletRonald K Hambleton

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Citations

Apr 10, 2014·BMC Medical Education·Catharina M HaringCornelis T Postma
Mar 2, 2011·Medical Teacher·Hiroshi NishigoriJunji Otaki
Jan 11, 2012·Prehospital Emergency Care : Official Journal of the National Association of EMS Physicians and the National Association of State EMS Directors·Melisa MartinMichael E Richards
Dec 10, 2016·The Clinical Teacher·Sharon AllenJames Nixon
Nov 24, 2006·Academic Medicine : Journal of the Association of American Medical Colleges·Rachel YudkowskyLeslie J Sandlow
Oct 18, 2007·Academic Medicine : Journal of the Association of American Medical Colleges·Reed G WilliamsNicole K Roberts
Jan 23, 2014·Academic Medicine : Journal of the Association of American Medical Colleges·Toshiko UchidaHeather L Heiman
Sep 5, 2014·Simulation in Healthcare : Journal of the Society for Simulation in Healthcare·Rachel YudkowskyCindy Ledonne
Dec 20, 2020·PM & R : the Journal of Injury, Function, and Rehabilitation·Robert BowersWalter Sussman

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