POSTER

Implementation of a Curriculum to Teach the Pediatric Physical Examination

Background: There is growing evidence that physicians lack basic clinical skills. An informal survey of 3^rd year students on our clerkship revealed the majority had not been taught how to perform a pediatric physical examination.

Methods: The curriculum was implemented in phases, first using the COMSEP physical examination video coupled with a requirement for 3 observed physical examinations (infant, toddler and adolescent). After the first year, students had to complete 2 observed examinations. Specific benchmarks, articulating what the students were expected to DO and KNOW, were added in the third year. Student comments about the curriculum were solicited as a part of the end of clerkship evaluation and analyzed.

Results: Data is available from July 2002-December 2004, reflecting all three phases of curriculum implementation. During the first and second years, student in the academic training center rated the experience more favorably than those in community sites (82% vs. 39%). In the current year, the majority of students rate the experience favorably (81% academic site vs. 77% community site). Negative comments reflected student's perception that the observed component was "unnecessary", "busy work" or a "hoop" that they had to complete for the rotation. Positive comments reflected the value of one on one teaching, the opportunity for feedback and observing an experienced faculty member perform parts of the exam.

Conclusions: Clearly articulating the curriculum, and the purpose of each component will enhance student's acceptance of the teaching program about physical examination skills.