POSTER

When & How to Teach Pediatric History & Physical Diagnosis in Medical School

Authors: Amy B. L. Guiot, MD; Raymond C. Baker, MD, M.Ed.
Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio

Background: History and physical diagnosis skills (HPDS) are required curriculum in medical schools. Our institution has no formal pediatric HPDS course. Deficiencies in these skills on the pediatric clerkship are prompting us to consider developing a course. In the absence of a universal curriculum, we would like to learn how other medical schools address pediatric HPDS to guide our effort.

Objective: To determine when and how pediatric HPDS are taught.

Methods: Using the Council on Medical Student Education in Pediatrics Directory, we contacted 30 pediatric clerkship directors from large, urban medical schools requesting a phone interview to discuss when and how medical students are taught pediatric HPDS.

Results: Nineteen medical schools (63%) participated in 20-min. phone interview. During the first year, eight offered limited experience in pediatric HPDS. During the second year, 15 offered pediatric HPDS each with variability in depth, time, and patient's ages. Methodologies included newborn exams, didactic lectures describing pediatric versus adult exam, instructional videos, or work with preceptors. During the second year, students experienced between 0-6 sessions dedicated to hands-on pediatric HPDS. Two schools did not introduce pediatric HPDS until the third year.

Conclusion:  This pilot study demonstrated that variability exists in how and when medical students are taught pediatric HPDS. This is not unexpected in the absence of a LCME mandated standard.  Since this small study surveyed only large institutions, a larger study is underway to determine the optimal time to provide HPDS instruction in the context of time, effort, and other resources.