"LET'S GET PHYSICAL!" EFFECTIVE AND EFFICIENT METHODS FOR TEACHING PHYSICAL EXAMINATION AT THE BEDSIDE
Eric K Zwemer,University of North Carolina School of Medicine,Chapel Hill,NC; Ann L. Kellams,University of Virginia,,; Charlotte Nussbaum,Children's Regional Hospital at Cooper/Cooper Medical School of Rowan University,,; Christine Gold,University of Colorado, Denver, Children's Hospital Colorado,,; Christine Marrese,The Children's Hospital at Montefiore,,; Maya K. Neeley,Vanderbilt Children's Hospital,,; Michael S. Ryan,Virginia Commonwealth University,,

Rationale:

Despite advances in medicine, the physical exam remains a crucial component of the care of hospitalized patients. Efficient and effective strategies are needed to ensure that learners at all levels become skilled in physical diagnosis. Bedside teaching skills training have been deemed a critical need in pediatric training, but many physicians feel uncomfortable teaching physical diagnostic skills to younger learners. In this engaging, hands-on workshop, participants will explore three physical exam bedside teaching techniques that are efficient, effective and fun for incorporation into family-centered rounds. The workshop is framed around published, effective bedside physical teaching techniques with an emphasis on practicing these techniques in small groups.  Feedback will be provided by peers and facilitators. Participants will leave the workshop with information and links to these and other bedside physical exam teaching techniques, and a commitment to incorporate one of these strategies the next time they round in the hospital.



Objectives:

By the conclusion of the workshop, the attendee will be able to:

  1. Identify barriers to teaching the physical exam at the bedside
  1. Compare and contrast different strategies for teaching the physical exam at the bedside
  1. Apply strategies for teaching the physical exam at the bedside in their clinical setting


Methods and Content:

Following a brief introduction, participants will then break out into small groups using a with a specific exam finding to practice how to incorporate each technique into rounds. In the final exercise, to apply what they have learned, each group will discuss the pros and cons of each technique for a specified scenario and level of learner. Feedback will be provided by peers and facilitators in a small group setting. Participants will leave the workshop with information about these and other techniques, and a plan to incorporate them the next time they round.

The 5-minute bedside moment is a scripted narrative describing the history or utility of physical exam maneuvers, followed by demonstration of the maneuver using appropriate technique.

The Compare/Contrast technique embraces the similarities and differences among patients in order to identify salient physical exam teaching points. Teachers and learners will perform the same specific evaluation on each patient using a collaborative discovery model (e.g., signs of increased work of breathing), contrasting the findings in each patient.

The Locate the Exam Finding exercise challenges learners to discuss and perform physical examination techniques to locate a known lesion or deficit in a hypothesis-driven manner.