Physical Diagnosis by KRb6iE

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									REQUIRED COURSE:

Course Title: Physical Diagnosis

Sponsoring Department or Unit: Medicine

List other departments with ongoing involvement in the course, and number of faculty
participating from each department:

              Medicine                                          10
              Family Medicine                                    1
              Neurology                                          2
              Pediatrics                                         2
              No Faculty Appointment or                         21
              Volunteer/Other


Time apportionment for required activities:

                     Activity:                       Scheduled Contact
                                                          Hours:
                     Lecture                                22
                     Laboratory                              0
                     Small-group discussion                  9
                     Patient contact                       30.5
                     Examinations                            3
                     Computer-based learning                 0
                     Other (Video-                           3
                     Demonstration)
                     Total                                   67.5


Evaluate the appropriateness of the course’s location in the curriculum with respect to
preceding and following courses, and with respect to other courses taught concurrently.

The course runs in three separate segments in the second year. The first segment is a
22-hour lecture-based component housed in the 1st quarter, and covers the physical
exam features related to key organ systems in clinical medicine. The second segment
runs concurrently in the 1st quarter as well, and introduces the students to the normal
examination; students pair-up with a classmate and learn the instruments, technique,
and anatomy of the physical exam, in a small group setting under a physician’s
supervision. The final segment occurs in the 3rd quarter, and introduces the student to
clinical sessions at the hospital bedside. The students are assigned to groups of four,
and work with a physician tutor in the University hospital, or other affiliated hospitals.
IV. EDUCATIONAL PROGRAM FOR THE M.D. DEGREE:
    REQUIRED CLERKSHIP FORM – Page 1
Students value the placement of this clinical-bridging course, as it gives them the
opportunity to learn clinical medicine alongside their cardinal sciences, Pharmacology,
Pathology, and Microbiology, which also run in quarters 1, 2, and 3.


Educational objectives. Briefly summarize the educational objectives of the course in
terms of knowledge, skills, behaviors and attitudes that students should exhibit upon its
completion. How are these objectives communicated to students? What evidence,
other than examinations given during the course, indicates that the objectives have
been achieved?

The educational objectives of the physical diagnosis course are to provide students with
their first hands-on experience in the clinical arena; teach them an organized,
systematic, technically accurate professional approach to the physical examination;
allow them to appreciate the relevance of basic sciences to patient care; and to excite
them about their future in clinical medicine.

The students receive the syllabus at the onset of the course, and the written objectives
are part of the material handed out. In addition, the objectives are discussed at the
opening lecture for the course.

When asked if the course objectives were met, historically, 88% to 92% of students
have answered in the affirmative.

Evaluation of student performance. Briefly describe the evaluation system used in the
course. How do you identify students exhibiting academic difficulty during the course,
and what remedial options are provided for students who fail the course?

The final grade in this course is based on a composite of the results of the final written
examination, the grade from the normal examination sessions, and the evaluation by
tutors on clinical competence developed during the in-hospital experience. Different
weights may be given to these areas depending on varying circumstances. Students
who prove deficient in one of these arenas are given an opportunity through a
remediation exercise to demonstrate competence in the physical examination. The
course director works directly with the student to review their weaknesses and prepare
them for a successful remediation.




IV. EDUCATIONAL PROGRAM FOR THE M.D. DEGREE:
    REQUIRED CLERKSHIP FORM – Page 2
Evaluation Methods

1. Indicate percent composition of student’s final grade (should sum to 100%):

Inter                 NBME       Faculty/Prec            Paper/Othe
        Laborat                                 OSCE/                     Other
 nal                 Subject        eptor/                    r
          ory/                                   SP                     (describe
Exam                 (“shelf”)     Resident                Written
        Practical                               Exam                     below)
  s                    Exam        Ratings                Exercise
40%      30%                         30%


Other method(s) noted above:


2. Number of internally prepared exams: ___1__ For credit        ___0__Not for credit

3. Format of internally prepared, for credit exams (check all that apply):

        _X__Multiple-choice, true/false, matching

        _____Open-ended, short answer

        _____ Essay

        _____ Oral

        _____ Laboratory/practical

        _____ Computer-based (any format)

        _____ Other (describe)

4. Do internal examinations include problem-solving exercises?

        __X__ Yes                 _____ No

5. If NBME subject (“shelf”) examinations are used, give mean scores for the last three
classes: NA

Year:   N/A                       _____               _____

Score: N/A                        _____               _____



IV. EDUCATIONAL PROGRAM FOR THE M.D. DEGREE:
    REQUIRED CLERKSHIP FORM – Page 3
Course evaluation. Describe the methods used to evaluate course quality. Identify
major successes of the course and challenges not yet surmounted.

The course is evaluated in an end-of-course web-based survey. Although responding to
the survey is not mandatory, the typical response rate among students is about 78-
85%. This course tends to be very well received by students. The course director has
been honored several times by students with a “Golden Apple” nomination. Successes
would include the ability of students to learn the complete physical examination in a
comfortable, structured buddy-system setting, without the attendant anxiety of
performing on a patient. This gives the student ample opportunity to engage in
appropriate role-playing prior to entering the clinical setting. Challenges would include
the timing of the clinical sessions of the course, which ends in the 3rd quarter. Student
feedback expresses concern that these newly-learned skills are perishable, and are
often difficult to retain and recall at the start of third year.


List recommended or required learning materials (textbooks, databases, Web sites,
etc.):

RECOMMENDED:


Seidel HM, Ball JW, Dais JE, Benedict GW. Mosby’s Guide to Physical Examination. 5th
Ed The CV Mosby Co. 2002

Bickley LS. Bates’ Guide to Physical Examination and History Taking. 7th Ed. JB
Lippencott Co. 1999

Swartz, Mark H. Textbook of Physical Diagnosis 4th Ed. WB Saunders Co. 2002


Sapira J Sapira’s Art and Science of Bedside Diagnosis 2nd Ed. Lippencott. 2000




IV. EDUCATIONAL PROGRAM FOR THE M.D. DEGREE:
    REQUIRED CLERKSHIP FORM – Page 4

								
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