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• W2327605440 abstract "OPEN ACCESSJune 20, 2011Hypothesis-Driven Physical Examination Student Handbook Rachel Yudkowsky, Junji Otaki, MD, DMedSc, Georges Bordage, MD, PhD, Tali Lowenstein, MD, Janet Riddle, MD, Hiroshi Nishigori, MD, MMEd, PhD Rachel Yudkowsky University of Illinois College of Medicine Google Scholar More articles by this author , Junji Otaki, MD, DMedSc Tokyo Medical University Google Scholar More articles by this author , Georges Bordage, MD, PhD University of Illinois College of Medicine Google Scholar More articles by this author , Tali Lowenstein, MD Clalit Health Services Haifa University Google Scholar More articles by this author , Janet Riddle, MD University of Illinois College of Medicine Google Scholar More articles by this author , Hiroshi Nishigori, MD, MMEd, PhD University of Tokyo Google Scholar More articles by this author https://doi.org/10.15766/mep_2374-8265.8294 SectionsAbout ToolsDownload Citations ShareFacebookTwitterEmail AbstractA common approach to teaching and assessing the physical exam is to have medical students first learn 140 or so maneuvers, from head to toes, and then demonstrate mastery of the maneuvers using a standardized patient checklist. This approach tends to decontextualize the physical exam. While students can learn the individual maneuvers, they may be unable to put the pieces together in a useful structural pattern that they can use to analyze and sort out a differential diagnosis at the bedside. The Hypothesis-Driven Physical Examination (HDPE) was originally developed as an assessment procedure in which students use a differential diagnosis to anticipate discriminating physical findings, execute the maneuvers, appreciate the patient's findings, and interpret the findings by offering the most likely diagnosis. This resource, the HDPE Student Study Guide, contains 160 physical exam maneuvers grouped according to 19 chief complaints, each with three to four relevant prototypical diagnoses, for a total of 60 distinct diagnoses. The maneuvers are presented as a series of charts. Medical students tested with this HDPE procedure, which included immediate feedback from a patient instructor (specialized standardized patient), performed better 1 year later. As few as 12 cases can be used to reliably (Cronbach's α >.80) assess mastery. The main purpose of the HDPE is to promote contextualized and meaningful learning and help provide a more selective approach to physical diagnosis, focusing on key, discriminating clinical findings as well as an array of structural patterns that can facilitate transfer from preclinical to clinical settings and from patient to patient. Educational Objectives After using this guide, learners will be able to: Identify the discriminating signs (physical exam maneuvers) for pairs of diagnoses related to 19 chief complaints.Use the discriminating signs to anticipate, elicit, and interpret physical findings for 19 chief complaints (for a total of 160 physical exam maneuvers and 60 diagnoses). Sign up for the latest publications from MedEdPORTAL Add your email below FILES INCLUDEDReferencesRelatedDetails FILES INCLUDED Included in this publication: Hypothesis-driven PE Student.pdf To view all publication components, extract (i.e., unzip) them from the downloaded .zip file. Download editor’s noteThis publication may contain technology or a display format that is no longer in use. CitationYudkowsky R, Otaki J, Bordage G, Lowenstein T, Riddle J, Nishigori H. Hypothesis-Driven Physical Examination Student Handbook. MedEdPORTAL. 2011;7:8294. https://doi.org/10.15766/mep_2374-8265.8294 Copyright & Permissions© 2011 Yudkowsky et al. This is an open-access publication distributed under the terms of the Creative Commons Attribution-NonCommercial-Share Alike license.KeywordsChief ComplaintChecklistManeuversPhysical Examination Disclosures None to report. Funding/Support This research was supported by a grant from the Edward J. Stemmler Medical Education Research Fund of the National Board of Medical Examiners (NBME), Philadelphia, as well as a grant-in-aid for scientific research from the Japanese Ministry of Education, Culture, Sports, Science and Technology, Tokyo. tabs.loading" @default.
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