Improving the efficiency of physical examination services.
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ABSTRACT:
SUBMITTER: Song WT
PROVIDER: S-EPMC2904461 | biostudies-literature | 2010 Aug
REPOSITORIES: biostudies-literature
Publications
Improving the efficiency of physical examination services.
Song Wheyming Tina WT Chih Mingchang M Bair Aaron E AE
Journal of medical systems 20090428 4
The objective of our project was to improve the efficiency of the physical examination screening service of a large hospital system. We began with a detailed simulation model to explore the relationships between four performance measures and three decision factors. We then attempted to identify the optimal physician inquiry starting time by solving a goal-programming problem, where the objective function includes multiple goals. One of our simulation results shows that the proposed optimal physi ...[more]
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Project description:Introduction/Project description: Several studies have revealed insufficient physical examination skills among medical students, both with regard to the completeness of the physical examination and the accuracy of the techniques used. FAMULATUR PLUS was developed in response to these findings. As part of this practice-oriented instructional intervention, physical examination skills should be taught through examination seminars and problem-oriented learning approaches. In order to ensure practical relevance, all courses are integrated into a 30-day clinical traineeship in the surgery or internal medicine department of a hospital (FAMULATUR PLUS). Research question: Does participation in the FAMULATUR PLUS project lead to a more optimistic self-assessment of examination skills and/or improved performance of the physical examination? Methodology: A total of 49 medical students participated in the study. The inclusion criteria were as follows: enrollment in the clinical studies element of their degree program at the University of Ulm and completion of the university course in internal medicine examinations. Based on their personal preferences, students were assigned to either the intervention (surgery/internal medicine; n=24) or the control group (internal medicine; n=25). All students completed a self-assessment of their physical examination skills in the form of a questionnaire. However, practical examination skills were only assessed in the students in the intervention group. These students were asked to carry out a general physical examination of the simulation patient, which was recorded and evaluated in a standardized manner. In both instances, data collection was carried out prior to and after the intervention. Results: The scores arising from the student self-assessment in the intervention (IG) and control groups (CG) improves significantly in the pre-post comparison, with average scores increasing from 3.83 (±0.72; IG) and 3.54 (±0.37; CG) to 1.92 (±0.65; IG) and 3.23 (±0.73; CG). The general physical examination, which was only assessed among the students in the intervention group, was performed more completely after the instructional intervention than prior to it. Discussion: On the basis of the data collected, it can be deduced that the FAMULATUR PLUS course has a positive effect on the self-assessment of medical students with regard to their physical examination skills. The validity of this conclusion is limited by the small sample size. In addition, it remains unclear whether a more positive self-assessment correlates with an objective improvement in physical examination skills.
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