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Tip of the week: Use the medical interview to build residents’ knowledge

Residency Program Connection, June 29, 2010

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There several teaching strategies medical educators can utilize to enhance medical knowledge. One strategy is to link instruction in the medical interview and physical exams to clinical cases.

When preclinical medical students are learning the language of clinical case presentations, physical examination techniques, and relevant epidemiological and social-behavioral sciences, faculty members should organize curricula around clinical cases. The traditional de-contextualized instruction of the physical examination may explain why students have difficulty selecting relevant examination components later on. Learning these skills in relationship to real clinical cases embeds relevant history and physical examination maneuvers in the diagnostic reasoning tasks of clinical training. Hypothesis-driven physical examination learning can result in students identifying more diagnostically meaningful and discriminating findings when examining standardized patients during their clinical skills assessment. Teaching purposeful inquiries and hypothesis-driven examination supports the development of early illness scripts as students link relevant history and examination features to diagnostic hypotheses.

This week’s tip is excerpted from A Practical Guide to Teaching and Assessing the ACGME Core Competencies, Second Edition, by Elizabeth A. Rider, MSW, MD and Ruth H. Nawotniak, MS, C-TAGME.

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