A Diagnostic Practice. The introduction of speciality-based physical examination / 医学教育

ABSTRACT

To improve physical examination skills of medical students, our original system of specialty-based physical examination (SBPE) was introduced into the diagnostic medical practice for 4th-year students. SBPE consisted of clinical practice and tests of every part of the physical examination which were administered and judged by each specialist, thereby greatly reducing the doctors' burden compared with a nonspecialist system. Because of the difficulty of preparing enough simulated or standardized patients, the medical interview was omitted from the system. Instead, the medical interview was directed stepwise according to a separate curriculum. Thus, these characteristics made SBPE much more practical to introduce. Results with this SBPE and those with a previous non-SBPE system were compared; the SBPE succeeded in reducing the number of “poor” grades and increasing the number of “good” grades on the test. These results demonstrate that SBPE is clinically efficacious because specialists could make an accurate evaluation and because the introduction of SBPE strongly motivated students.