Continuous Improvement in Pre-Clerkship Physical Examination Teaching: Experience at A Medical Center in Taiwan

Bai-Chin Lee ； Jann-Yuan Wang ； Chong-Jen Yu ； Shan-Chwen Chang ； Fen-Yu Tseng

《Journal of Medical Education》 22卷3期 (2018/09) Pp. 89-97

https://doi.org/10.6145/jme.201806.0010

摘要

Purpose: Teaching of processes involved in physical examination (PE) is an important part of medical education. We report our experience with continuous improvements in pre-clerkship PE teaching. Methods: The pre-clerkship PE teaching curriculum in our medical school was designed for fourth-year medical students (M4). Students learned history-taking, PE, medical-chart writing, and clinical reasoning in small groups with clinical physicians invited as tutors. We developed demonstration videos for key PE skills, held workshops, and implemented group PE contests (GPECs) to enhance student interest and learning outcomes. Results: Demonstration videos were prepared by senior instructors for the M4 curriculum and were uploaded to our teaching website. Workshops for tutors were held routinely to standardize teaching styles. Student opinions were collected at meetings during each semester. We held the GPEC in June 2017. The tutors selected 12 specific signs for students to present during the final class of the semester. Each group had to report the origins, skills of performing, physiological and pathological meanings, the sensitivity and specificity, and the confounding factors of the sign. Group scores were given by all the tutors and students. Awards were given to the top 3 groups. The presentations by the students were innovative. The GPEC enhanced students' PE learning. Conclusions: We organized tutor-based workshops, prepared new teaching materials, and implemented GPECs to improve PE teaching continuously. GPECs enhanced student interest, understandings, and PE skills. New curriculum designs to curriculum may improve leaning outcomes in students.

關鍵字

continuous improvement in physical examination teaching ； group physical examination contest

參考文獻

Peixoto, AJ(2001).Birth, death, and resurrection of the physical examination: clinical and academic perspectives on bedside diagnosis.Yale J Biol Med.74,221-8.

Jauhar, S(2006).The demise of the physical exam.N Engl J Med.354,548-51.

Nikendei, C,Kraus, B,Schrauth, M(2008).How prepared are future doctors?.Med Teach.30,88-91.

Haring, CM,Cools, BM,van der Meer, JW(2014).Student performance of the general physical examination in internal medicine: an observational study.BMC Med Educ.14,73.

Krautter, M,Diefenbacher, K,Koehl-Hackert, N(2015).Short communication: Final year students' deficits in physical examination skills performance in Germany.Z Evid Fortbild Qual Gesundhwes.109,59-61.