Assessing the relationship between cardiac physical examination technique and accurate bedside diagnosis during an objective structured clinical examination (OSCE)

Rose Hatala, Barry Issenberg, Barry O. Kassen, Gary Cole, C. Maria Bacchus, Ross Scalese

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

BACKGROUND: Many standardized patient (SP) encounters employ SPs without physical findings and, thus, assess physical examination technique. The relationship between technique, accurate bedside diagnosis, and global competence in physical examination remains unclear. METHOD: Twenty-eight internists undertook a cardiac physical examination objective structured clinical examination, using three modalities: real cardiac patients (RP), "normal" SPs combined with related cardiac audio-video simulations, and a cardiology patient simulator (CPS). Two examiners assessed physical examination technique and global bedside competence. Accuracy of cardiac diagnosis was scored separately. RESULTS: The correlation coefficients between participants' physical examination technique and diagnostic accuracy were 0.39 for RP (P < .05), 0.29 for SP, and 0.30 for CPS. Patient modality impacted the relative weighting of technique and diagnostic accuracy in the determination of global competence. CONCLUSIONS: Assessments of physical examination competence should evaluate both technique and diagnostic accuracy. Patient modality affects the relative contributions of each outcome towards a global rating.

Original languageEnglish
JournalAcademic Medicine
Volume82
Issue number10 SUPPL.
DOIs
StatePublished - Oct 1 2007
Externally publishedYes

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Physical Examination
examination
Mental Competency
diagnostic
Cardiology
examiner
weighting
video
rating
simulation

ASJC Scopus subject areas

  • Nursing(all)
  • Public Health, Environmental and Occupational Health
  • Education

Cite this

Assessing the relationship between cardiac physical examination technique and accurate bedside diagnosis during an objective structured clinical examination (OSCE). / Hatala, Rose; Issenberg, Barry; Kassen, Barry O.; Cole, Gary; Bacchus, C. Maria; Scalese, Ross.

In: Academic Medicine, Vol. 82, No. 10 SUPPL., 01.10.2007.

Research output: Contribution to journalArticle

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N2 - BACKGROUND: Many standardized patient (SP) encounters employ SPs without physical findings and, thus, assess physical examination technique. The relationship between technique, accurate bedside diagnosis, and global competence in physical examination remains unclear. METHOD: Twenty-eight internists undertook a cardiac physical examination objective structured clinical examination, using three modalities: real cardiac patients (RP), "normal" SPs combined with related cardiac audio-video simulations, and a cardiology patient simulator (CPS). Two examiners assessed physical examination technique and global bedside competence. Accuracy of cardiac diagnosis was scored separately. RESULTS: The correlation coefficients between participants' physical examination technique and diagnostic accuracy were 0.39 for RP (P < .05), 0.29 for SP, and 0.30 for CPS. Patient modality impacted the relative weighting of technique and diagnostic accuracy in the determination of global competence. CONCLUSIONS: Assessments of physical examination competence should evaluate both technique and diagnostic accuracy. Patient modality affects the relative contributions of each outcome towards a global rating.

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