• Mark J Fagan, Rebecca A Griffith, Laura Obbard, and Carolyn J O'Connor.
• Division of General Internal Medicine, Department of Medicine, Brown Medical School, Providence, RI, USA. MFagan@lifespan.org
• J Gen Intern Med. 2003 Aug 1; 18 (8): 652655652-5.

ObjectiveTo determine if a literature-based physical diagnosis curriculum could improve student knowledge, skill, and self-confidence in physical diagnosis.DesignProspective controlled trial of an educational intervention.SettingRequired internal medicine clerkship for third-year medical students at Brown Medical School.ParticipantsThird-year medical students who completed the internal medicine clerkship during the academic year 1999-2000: 32 students at 1 clerkship site received the intervention; a total of 50 students at 3 other clerkship sites served as controls.InterventionPhysical diagnosis curriculum based on 8 articles from the Journal of the American Medical Association's Rational Clinical Examination series. Intervention students met weekly for 1 hour with a preceptor to review each article, discuss the sensitivity and specificity of the maneuvers and findings, and practice the techniques with an inpatient who agreed to be visited and examined.Measurements And Main ResultsPhysical diagnosis knowledge for the 8 topics was evaluated using a 22-item multiple choice question quiz, skill was evaluated using trained evaluators, and self-confidence was assessed using an end-of-clerkship survey. Intervention students scored significantly higher than the control group on the knowledge quiz (mean correct score 70% vs 63%, P =.002), skills assessment (mean correct score 90% vs 54%, P <.001), and self-confidence score (mean total score 40 vs 35, P =.003), and they expressed greater satisfaction with the physical diagnosis teaching they received in the clerkship.ConclusionThis physical diagnosis curriculum was successful in improving students' knowledge, skill, and self-confidence in physical diagnosis.

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