Course Goals

• Prepare students for their third-year clinical clerkships with competency of medical history taking, and an introduction to the complete physical examination
• Increase students' knowledge about behavioral sciences concepts relevant to medical practice
• Foster students' acquisition of life-long, self-directed learning skills
• Foster students' professional development as future clinicians
• Integrate clinical and basic science concepts relevant to medical practice
• Emphasize the ethical and basic science concepts relevant to medical practice
• Foster students’ acquisition of knowledge and skills needed in the prevention and resolution of ethical conflicts

Patient Care and Professional Development 

•  Demonstrate professionalism in patient care settings through dress, demeanor and appropriate communication.
• Participate in small-group settings in a cooperative, collegial manner with peers and instructors.
• Demonstrate respect for patients, other health care professionals, classmates and faculty.
• Accept opinions different from his or her own.
• Offer feedback to peers and accept feedback from peers.
• Promote altruism and dutifulness in self and others.
• Initiate an understanding of the psychological, sociocultural and familial factors that influence his/her behaviors as a student doctor and a physician.

Integration of Clinical and Basic Sciences 

• Recognize the role of the basic sciences in the clinical care of patients.

Course Objectives

By the end of the fall semester course the student should be able to:

Medical Interviewing Skills

• Define the components of the medical interview.
• Demonstrate the ability to conduct a medical interview.
• Describe effective medical interviewing techniques for establishing patient rapport and eliciting information.

Physical Examination Skills

• Each student must demonstrate competency of the technique of physical examination and become familiar with the usual findings of the physical examination of a patient.

Introduction

The second semester of first year was designed to provide students with detailed one on one instruction on how to perform the complete physical examination of the normal patient, after having been exposed to a complete review of clinical evaluations by attending introductory interactive lectures. Participation in the self-examination small group exercises in the spring semester should have enabled the students to develop appropriate clinical and technical skills.  In addition to cognitive knowledge, the technical ability, psychomotor and interpersonal skills, professional attitude, and practical experience were also emphasized during this Year 1 spring course.

The second year of Physical Diagnosis will introduce the abnormal components of the physical examination.   Students will experience both lectures and ward experience in both the fall and spring semesters.

Clinical Skills

The Basic Structure

Each student will interview and examine a total of four (4) patients.  Two students will be assigned to one instructor.  The students will present their history and physical to the instructor.  The instructors will assist the students with their presentation and see the patients at the bedside with both of their students.  Students will be assigned to the Medical University Hospital and Charleston VA Medical Center. 

• Will perform a history and physical examination;
• Meet with the instructor at his/her designated time, prepared to present the history and physical.
• The student will dress professionally and wear his or her white coat while at the bedside.
• The student will submit a "long form" write-up within 48 hours after each patient work-up to the instructor.

The students will present their history and physical examinations to the instructor.  The instructor and students will visit each patient at the bedside to review the pertinent history and physical findings.  After the session with the instructor, students will have 48 hours in which to write-up and submit a "long form" history and physical examination. The instructor will read, grade, and provide feedback on each written assignment.

At the end of the four sessions, every student should have worked with four patients, should have been observed taking a history and performing a physical exam at least once, and should have had the evaluation form completed, reviewed, and signed by the instructor.