Will clinical signs become myth? Developing structured Signs Circuits to improve medical students’ exposure to and confidence examining clinical signs

Autor: Dominic Merriott, George Ransley, Shadman Aziz, Krushna Patel, Molly Rhodes, Deborah Abraham, Katba Imansouren, Daniel Turton
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: Medical Education Online, Vol 27, Iss 1 (2022)
Druh dokumentu: article
ISSN: 10872981
1087-2981
DOI: 10.1080/10872981.2022.2050064
Popis: Background Correctly eliciting and interpreting physical examination (PEx) signs contributes to successful diagnosis and is fundamental to patient care. A significant decline in the time spent acquiring these skills by medical students, and the decreased ability to elicit and recognise signs is widely acknowledged. However, organising teaching to counteract this in the busy clinical environment is challenging. We evaluated the prior exposure to clinical signs, and experience of examination teaching among a cohort of final-year medical students. Following this, we assessed the utility of a structured circuit-based approach (Signs Circuits) using hospital inpatients and junior doctors to provide high-yield PEx teaching and overcome these limitations.Materials and methods Qualitative and quantitative survey feedback, including a standardised list of 62 clinical signs, was sought from final-year medical students during their rotations at a teaching hospital in London, UK, before and after the provision of Signs Circuits.Results Prior to the course the 63 students reported limited exposure to even the most common clinical signs. For example, the murmurs of mitral and tricuspid regurgitation and the sound of lung crackles eluded 43%, 87%, and 32%, respectively. From qualitative feedback, the reasons for this included that much of their prior PEx experience had focused on the performance of appropriate examination steps and techniques in patients without pathology. During the course, students were exposed to an average of 4.4 new signs, and left with increased confidence examining and eliciting signs, and a firmer belief in their importance to diagnosis.Conclusion Medical students continue to have limited exposure to clinical signs in medical school. This signs-focused approach to PEx teaching is an effective and reproducible way to counter the deficiencies identified in signs exposure.
Databáze: Directory of Open Access Journals
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