Lazarus Michael E, Hernandez Estebes A, Kahn Daniel G, Vigallon Stacey, Cooper Christopher B
Medicine, David Greffen School of Medicine, Los Angeles, California, 90095, USA.
Los Angeles Audubon Society, Los Angeles, California, 90066, USA.
MedEdPublish (2016). 2023 Jan 4;13:1. doi: 10.12688/mep.19397.1. eCollection 2023.
Proficiency in clinical examination skills upon graduation from medical school is a core competency. Over the last few decades, the ability and confidence in this fundamental and crucial skill set has declined. The motivation and interest in meticulous physical examination by recently graduated residents has also eroded. In this case study, we describe a comprehensive, innovative, and immersive advanced clinical skills elective taken during the second half of the final year of medical school for students at the David Geffen School of Medicine. The course utilizes novel approaches to inspire, refresh and consolidate essential bedside observation skills and examination techniques. This approach gives senior students the confidence and fundamental understanding of how dedication to the patient exam can improve the doctor-patient relationship, core clinical reasoning and the practice of cost-effective and evidence-based care through their careers. We describe how the integration of fine art appreciation and introductory biding techniques are used to help students hone their visual diagnostic skills. We show how this is solidified through a longitudinal series of clinical image review sessions with diagnostic reasoning principles to formulate a clear differential. Point of care ultrasound, EKG analysis, advanced cardiac auscultation and diagnostic imaging skills are integrated in a comprehensive and memorable fashion. We present this case study to inspire clinical skills teachers everywhere to replicate our methods in resurrecting the importance of physical exams for their learners. Opening their trainees' eyes to new methods of honing their visual intelligence and developing healthy habits for stress and burnout reduction will aid the rest of their professional careers.
医学院校毕业时具备临床检查技能是一项核心能力。在过去几十年里，这项基本且关键技能的能力和信心有所下降。刚毕业的住院医师对细致体格检查的积极性和兴趣也已减退。在本案例研究中，我们描述了在医学院校最后一年下半年为大卫·格芬医学院的学生开设的一门全面、创新且沉浸式的高级临床技能选修课。该课程采用新颖方法来激发、更新和巩固基本的床边观察技能及检查技术。这种方法让高年级学生对通过专注于患者检查如何在其职业生涯中改善医患关系、核心临床推理以及实施具有成本效益和循证医疗有信心并形成基本理解。我们描述了如何将美术鉴赏和入门级投标技术的整合用于帮助学生磨练其视觉诊断技能。我们展示了如何通过一系列纵向的临床图像回顾课程以及诊断推理原则来强化这一点，以形成明确的鉴别诊断。即时超声、心电图分析、高级心脏听诊和诊断成像技能以全面且令人难忘的方式整合在一起。我们呈现这个案例研究是为了激励各地的临床技能教师效仿我们的方法，让他们的学生重新认识体格检查的重要性。让他们的学员了解磨练视觉智能的新方法以及养成减轻压力和倦怠的健康习惯将有助于他们余下的职业生涯。
