Physical Examination

September 30, 2024-December 11, 2024

Course Director
Andrew Klein, MD, MS
Assistant Professor
Department of Medicine
kleinaj@upmc.edu

Course Description

This course is dedicated to teaching the art and science of performing a physical examination. The fundamental elements of physical examination are introduced in readings and videos preceding practice sessions where you will have the chance to practice the skills introduced. 

SP practice sessions and examination are also a part of this course to help you develop proficiency with your exam skills in a safe and life-like environment.  Students work in groups of approximately 5 students with your clinical skill preceptors there to help facilitate your learning the art and practice of physical examination.

Course Objectives:

1. Learn the techniques of the comprehensive physical examination.
2. Demonstrate and practice these techniques within the clinical context of a routine comprehensive physical examination.
3. Develop an organized and patient-centered approach to performing a complete physical examination.
4. Begin to differentiate between a screening physical examination and a more focused examination, and when each type of examination is indicated.
5. Demonstrate the use the following instruments:
   • otoscope
   • sphygmomanometer
   • stethoscope
   • reflex hammer
   • 128hz tuning fork
   • Snellen eye chart
6. Recognize key physiologic and pathologic physical examination findings and their significance​

Educational Methods

Educational methods are summarized below:

• Videos and web-based modules
• Small group practice and skill acquisition
• SP simulated exams
• Self-study

Assessment

Physical examination is both an art and a science and requires years to master. A passing grade requires that (1) satisfactory preparation and participation for each class session and (2) demonstration of a passing score (>90%) on the Observed Standardized Clinical Examination (OSCE) at the end of the course.

1. Preparation & Participation: The practice sessions are for you to practice the techniques and wording of the physical exam and to enable you to learn, make mistakes, and grow in a safe and comfortable setting. All we ask from you is a growth-mindset, enthusiasm, participation, and preparation.  Mastery in technique will develop with time throughout your training. As such, your evaluation from your CSP will be based predominantly on preparation, attitude, and effort; mastery of skill is not expected BUT some evidence of competence is.

2. Absences: Requests for excused absences should be submitted via Elentra. Unexcused absences may result in grading penalties as outlined in the Policy on Absence and Attendance. More than one excused absence or any unexcused absences will result in a grade of incomplete. All absences will require a demonstration of the exam skills covered in the missed session with either your CSP or Dr. Klein.

3. Demonstration of Physical Exam Skills: At the end of the course there will be an OSCE with a simulated/standardized patient (SP) and each student will be asked to demonstrate and perform a full physical examination. You must achieve a 90% score of physical exam checklist items (provided at the end of this syllabus) in order to pass the course. A CSP and SP will keep track of which exam skills you perform and provide feedback.

Requests for excused absences should be submitted via Elentra. Unexcused absences may result in grading penalties as outlined in the Policy on Absence and Attendance.