Medical teacher
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Physical examination (PEx) skills are declining among medical trainees, yet many institutions are not teaching these systematically and effectively. Many variables contribute to effective teaching: teachers' confidence in their clinical skills, ability to demonstrate and assess these skills; availability of suitable patients; trainee attitude and fatigue; belief that institutions do not value clinical teachers. Finally, the relevance and significance of a systematic exam must be demonstrated or the teaching degenerates into a 'show-and-tell' exercise. ⋯ PEx is important in patient-physician interactions, a valuable contributor to accurate clinical diagnosis and can be taught effectively using practical tips. To reverse the trend of deficient clinical skills, precision of clinical findings should be studied and exam manoeuvres that do not contribute to diagnosis discarded; institutions should value clinical skills teaching, appoint and fund core faculty to teach and provide staff development to improve teaching skills.
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Step 2 Clinical Skills (CS) was recently introduced into the United States Medical Licensing Examination (USMLE) to ensure that successful candidates for licensure possess the clinical skills to provide safe and effective patient care. ⋯ Over a third of medical schools are implementing changes to the objectives, content, and/or emphasis of their curriculum, at least partially in response to the institution of Step 2 CS.
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In 2004, the Japanese government reformed the monospecialty-oriented postgraduate medical education (PGME) program and introduced a new PGME program to develop the primary care skills of physicians by mandatory rotation through different clinical departments. ⋯ The new PGME program appears to have been successful at improving both the clinical experience and confidence levels of medical residents, especially at university hospitals.