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• W4247697231 abstract "We thank Dr. Weissman for his thoughtful discussion. We certainly agree with the fact that experienced clinicians and educators must remain an integral part of teaching history and physical examination skills to medical students. As Dr. Weissman pointed out, clinicians bring to the teaching encounter these fundamental skills and the critical perspective of patient care and patient relationships they have cultivated over years. In fact, the Clerkship Directors in Internal Medicine survey findings highlight that the overwhelming majority of respondents believed that physicians are critical to the success of any introduction to clinical medicine program. Nevertheless, the realities of recent years, with fewer patients in the hospital and fewer faculty available for teaching due to service demands, have necessitated changes in the way introduction to clinical medicine is taught. Standardized patients provide an important method by which students can learn fundamental skills in a setting that may help alleviate some of their anxieties. However, it is important to highlight that we are not advocating that standardized patients are the sole source of patient interactions during introduction to clinical medicine. Standardized patients provide an important supplemental method for students to learn clinical skills and also for evaluating these skills; however, they do not replace the need for students to interact with and evaluate patients during their preclinical years under the direct supervision of a physician. Similarly, although our survey findings reported that fourth year medical students and housestaff are participating in teaching introduction to clinical medicine courses, we failed to clarify whether they were teaching in a supervised setting, ie, that fourth year students and/or housestaff were learning to teach these skills under the guidance of an experienced teacher. Our anecdotal experience in speaking with introduction to clinical medicine directors is that such is the case, and thus experienced clinicians are helping to train not only the next generation of physicians, but the next generation of teachers as well. In an ideal world, patients and experienced physicians will have adequate time and talents to spend at the bedside teaching students these important bedside skills. In the meantime, alternative strategies such as careful planning and selection of educators in teaching roles could be successfully included in the curricula of many medical schools. However, we too hope that our “seasoned” physicians continue to actively educate our future physicians in introduction to clinical medicine courses. Teaching Clinical CompetenceThe American Journal of MedicineVol. 118Issue 11PreviewAs an experienced teacher of physical diagnosis, I find the report by Omori and colleagues1 regarding introduction to and clerkships in internal medicine of great concern. Its importance for medical education, patient care and research cannot be overemphasized. The quality of our future physicians rests upon a solution to the problems presented because medical care obligations to our increasing population, particularly the aged, continue to mount. The authors are to be commended for insightful diligence in their presentation. Full-Text PDF" @default.
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• W4247697231 date "2005-11-01" @default.
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• W4247697231 title "The Reply" @default.
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