Benjamin Jennifer C, Groner Judith, Walton Jennifer, Noritz Garey, Gascon Gregg M, Mahan John D
Assistant Professor, Department of Pediatrics, Baylor College of Medicine; Assistant Professor, Department of Pediatrics, Texas Children's Hospital.
Academic Pediatrics Fellowship Director, Ohio State University College of Medicine; Clinical Professor of Pediatrics, Division of Ambulatory Pediatrics, Nationwide Children's Hospital; Clinical Professor of Pediatrics, Division of Ambulatory Pediatrics, Ohio State University College of Medicine.
MedEdPORTAL. 2019 Jan 4;15:10792. doi: 10.15766/mep_2374-8265.10792.
Children with neuromuscular disabilities (NMD) receive care in a wide variety of clinical settings. Residents lack training to develop physical examination skills for evaluating patients with NMD. We devised a curriculum to teach residents how to examine patients with NMD using a systematic and simplified approach.
Creation of this resource was a response to a survey of final-year residents that revealed the need for education focused on developing physical examination skills. The curriculum has four components-multimedia PowerPoint with embedded video, knowledge assessment, clinical exam (CEX) assessment, and module feedback-and was completed by 37 residents over an 8-month period from January to September 2016. We utilized knowledge assessment, direct clinical skills observation using the CEX, and module-feedback responses as part of the evaluation.
All 37 residents completed the curriculum, with an overall knowledge score of greater than 80%. Residents demonstrated most of the desired patient care behaviors on the CEX assessment and provided positive feedback on the quality, usefulness, and applicability of the module, in addition to requesting more curricula to develop their physical examination skills.
The CEX assessment provided a unique opportunity for faculty feedback on residents' physical exam performance. After completing the module, residents achieved high scores in most areas of the standardized CEX and were able to conduct the NMD physical exam in a sensitive manner. The assessment highlighted the need to improve residents' skills of detecting abnormal clinical findings and communicating with the patient during the physical exam.
神经肌肉残疾（NMD）患儿在多种临床环境中接受治疗。住院医师缺乏评估NMD患者的体格检查技能培训。我们设计了一门课程，以教导住院医师如何使用系统且简化的方法检查NMD患者。
创建此资源是对最后一年住院医师的一项调查的回应，该调查显示需要开展侧重于培养体格检查技能的教育。该课程有四个组成部分——带有嵌入式视频的多媒体PowerPoint、知识评估、临床技能考核（CEX）评估和模块反馈——在2016年1月至9月的8个月期间，37名住院医师完成了该课程。我们将知识评估、使用CEX进行直接临床技能观察以及模块反馈回复作为评估的一部分。
所有37名住院医师都完成了该课程，总体知识得分超过80%。住院医师在CEX评估中展现出了大多数期望具备的患者护理行为，并对该模块的质量、实用性和适用性给予了积极反馈，此外还要求提供更多课程以培养他们的体格检查技能。
CEX评估为教员提供了一个就住院医师的体格检查表现给予反馈的独特机会。完成该模块后，住院医师在标准化CEX的大多数领域都取得了高分，并且能够以敏锐的方式进行NMD体格检查。该评估突出了提高住院医师在体格检查过程中发现异常临床体征以及与患者沟通的技能的必要性。
