Council on Medical Student Education in Pediatrics


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COMSEP Meeting in Ottawa, ON

Poster Presentation:

Direct Observation of Student Physical Exam Skills using an iPad Application

Meghan D. Treitz,University of Colorado School of Medicine,Aurora,CO,Jason Zamkoff,University of Colorado School of Medicine,Aurora,CO,Jason Owens,University of Colorado School of Medicine,Aurora ,CO,Jennifer Soep,University of Colorado School of Medicine,Aurora,CO,Janice L. Hanson,University of Colorado School of Medicine,Aurora,CO


Direct observation is an important tool for assessment of medical student performance.  Through direct observation, students are assessed in a clinical setting with actual patients.  Barriers include faculty time and skill (1).  To address these barriers, we implemented a program to assess student physical exam skills using an iPad application, “Coach’s Eye.” 


To develop a method for using an iPad application to asynchronously observe and assess student respiratory exam skills, allowing for student self-reflection and faculty feedback. 


Through this method, 16 students recorded a patient encounter and received feedback within a day of turning in the iPad.  Feedback took 15 minutes per video.  The most common feedback given to students included suggestions on technique and identification of missing portions of the exam.  Since the cloud could not be used to transfer video commentary between student and faculty due to institution privacy constraints, a cumbersome work-around involved the students physically turning in iPads at the rotation midpoint for an attending to review and comment on videos.  Field notes emphasized the need for clear, structured instructions for students to ensure the process worked smoothly.


Use of the Coach’s Eye application is an innovative approach to Direct Observation in a clinical setting that allows for both student self-reflection and faculty feedback.  Student orientation to the app, a close relationship with IT and the compliance office, and institutional devices to protect patient confidentiality are needed.  While there are barriers that must be overcome, the approach provides an alternate method of feedback that approximates direct observation.