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Additional adjunct faculty and preceptors may be utilized during the course as
needed. They will evaluate students during skills sessions and practical
examinations.
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Description: This course is a continuation of Clinical Examination OMS1. The
student will continue to practice their patient interview techniques and
demonstrate a proper physical examination. The course will define the structure
and components of a medical history and how to record it. Competency in
interpersonal skills is enhanced by the introduction and development of
empathetic listening, recognizing non-verbal cues, and cultural awareness.
The student will review the medical history and physical examination skills
pertinent to the organ system under study. Common pathologic conditions within
the organ system are in the required textbook and may be discussed in the
presentations.
Credit Hours: per Student Handbook
Goals: Students are to develop competence in obtaining and recording a
medical history and performing a physical examination of the organ systems
covered during this and the previous academic year.
Learning Objectives: Upon successful completion of this course, the student
will be able to:
a. Demonstrate the ability to perform a focused medical history and physical
examination on a standardized patient (SP) within given time constraints
b. Demonstrate a professional demeanor while performing a focused medical
history and physical examination on a SP
c. Demonstrate the ability to use common medical equipment
d. Correctly identify anatomical landmarks that are significant in a physical
examination
e. Correctly identify and explain the significance of abnormal physical findings
f. Record the history and physical findings in a standard SOAP format
Rationale: An adequate history and physical examination is fundamental to the
clinical diagnosis and treatment of medical conditions. To that end, this course
will teach the student how to perform a medical history and thorough physical
examination and accurately record the findings.
Overview: Clinical Examination is organized as a systems-based course as
follows:
Semester I (Fall) Cardiac, EKG Tracings, Abdomen, Female Genitalia, Male
Genitalia, Anus, Rectum, and Prostate
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Methodology: All students will meet as a group for scheduled lectures. At other
times the students will meet in small groups with a faculty member and/or upper
class member, and a SP to participate in skill sessions and workshops. In skill
sessions, the student will be instructed in techniques of obtaining a relevant
history and performing a focused physical examination. Workshops by the
student will focus on obtaining and recording a history from a SP relevant to the
organ system being studied and performing a focused physical examination of
that system/region. Encounter write-ups will be evaluated by the clinical faculty
for progression and completeness.
Scheduled Meetings: Lectures will be given at times indicated in a separate
semester schedule. Skill sessions and focused exam workshops will be
scheduled throughout the semesters. These schedules will be on the Master
Schedule and in a separate posting on the LECOM Portal.
Required Textbook:
Seidel, Henry M., Mosbys Guide to Physical Examination, Seventh Edition 2011,
Mosby St. Louis. ISBN#978-0-323-05570-3
Garcia, Thomas B., 12-Lead ECG, The Art of Interpretation, Second Edition
2014, Jones and Bartlett, Sudbury, MA, ISBN # 978-0-7637-7351-9
The faculty expects that assigned readings will be completed prior to class
meetings.
Recommended Materials:
Tierney, Lawrence M. & Henderson, Mark C. (Ed.), The Patient History:
Evidence-Based Approach, 2005, McGraw-Hill New York. ISBN # 0-07-140260
Eight copies will be available in the library.
Satcher, David, Multicultural Medicine and Health Disparities, 2006, McGraw-Hill
New York ISBN #0-07-143680 Four copies will are available in the library.
Seidel: Mosbys Physical Examination Video Series, Version 2
http://medicine.ucsd.edu/clinicalmed/introduction.htlm
http://library.med.utah.edu/kw/ecg/
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Required Equipment:
Blood pressure cuff
Stethoscope
Penlight
Reflex hammer
Rosenbaum eye chart (Near Vision)
Tuning forks (128 Hz and 512 Hz)
Otoscope/ophthalmoscope
Ruler or tape measure (cm)
Watch with a means to measure seconds
Policies:
Attendance - LECOM-Bradenton has a mandatory attendance policy.
Students who are absent may be referred to the Student Promotion and
Graduation Committee per the LECOM-Bradenton Student Handbook.
Class Participation - Clinical medicine is by necessity interactive. Therefore,
students must participate in all skill sessions. The student must come to the skill
sessions prepared to perform the examination and discuss the findings and their
significance.
Attire and Medical Equipment - Students are expected to maintain a
professional appearance (clean white coat with nametag) for each skills session/
SP encounter. You are permitted to be in clothing required for OMM on days
when you have OMM lab. You should avoid extremes in fashion and personal
appearance. You are required to bring any relevant medical equipment with you
to the skills sessions, focused workshops, SCF, VTHP, and OSCE.
Scheduling
a. Attendance at scheduled appointments is mandatory. The course director will
approve an excused absence only under extreme circumstances, with
documentation from the Office of Student Affairs. It is the students responsibility
to inform the course directors of an absence by email so that a make-up session
may be arranged.
b. Learning issues for each specific skill session consist of demonstration of the
skills listed on the physical examination check-list. These lists will be distributed
to the students in advance of every scheduled skill session.
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c. The Patient Encounter Suite will be scheduled by Ms. Cinda Roberts.
d. Changes: Due to the challenge of scheduling a large number of individual
students, requests for time changes will not be honored except for emergency
situations. All schedule changes must be requested a minimum of one
workday in advance via email to Cinda Roberts at croberts@lecom.edu.
e. When a scheduled appointment has been rescheduled due to an unexcused
absence, a monetary fee based on the required staffing will be assessed.
*Please note that the course schedule may have to be altered due to
unforeseen circumstances. If that becomes necessary, students will be
notified at the earliest opportunity.
Skills Sessions
A skills session is a hands-on approach. Students will be organized in small
groups to practice relevant skills of each organ system. Each group will have a
clinical preceptor to reinforce previously demonstrated techniques and observe
student skills. Students are encouraged to help and coach each other during the
sessions as a means of preparing for work in physician team settings. The
clinical preceptor may question students regarding pathophysiology and
abnormal findings relevant to the organ system covered during the skill session.
Please Note: The skill sessions will start with a 5 question fill-in-the-blank quiz
on that skill area. The skill sessions instruct students in the correct method of
performing physical examinations, but it is the students responsibility to practice
techniques outside of class time to attain proficiency and increase their speed of
examination.
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stop immediately and return to the hall. Following the patient encounter, you will
type your findings, print, and submit.
ATTIRE and EQUIPMENT: per Clinical Examination policy on attire and
equipment.
TIME: Arrival times will be posted with your assignment. Being late may be
considered an unexcused absence.
PLACE: LECOM Patient Encounter Area. Please gather and wait in the outside
hallway area across from the OMM labs until someone comes to get you.
PRACTICE: If you would like additional practice time in one of the clinical skills
exam rooms please contact Cinda Roberts croberts@lecom.edu or 782-5985.
The faculty is available by appointment for additional help.
Student Evaluation
Your final grade for the course will be based on written examinations, fill-in
the blank quizzes with the skills sessions, and subjective review by our
standardized patients and clinicians.
The weighting of this semester is 55% from the written examinations and quizzes
and 45% from your Patient Encounter Suite/State College of Florida activities.
The Patient Encounter Suite activities are broken down as 4% for quizzes, 10%
for OSCE, 6% for SCF, 12% for VTHP, and 13% for FEWs.
The second examination may be cumulative, containing less than 10% from
previous material.
A final score of 69.5% will be rounded up to 70%. (79.5% to 80%, 89.5% to 90%)
Clinical Examinations requires mastery of examination skills. Using the format for
COMLEX-PE, your FEW/OSCE will be evaluated for; global skills, examination
skills, OMM, and SOAP format documentation. These will be assigned points
based on subjective criteria; Competent, Marginal, Poor.
If you believe that your examiner has not evaluated you in a fair manner, you
must register your complaint with the course coordinators within 7 days of the
date that your grades are available. Any student failure will be addressed
according to the procedures outlined in the LECOM-Bradenton Academic
Catalog and Student Handbook.
Professionalism is a core competency that is monitored by attendance and the
improvement of interpersonal skills. Documented tardiness will result in the
loss of 0.5 percentage point per occurrence and unexcused absences will
result in a loss of 1 percentage point per occurrence from the final semester
grade.
Medical knowledge is a core competency that requires medical equipment to
increase skill and proficiency. Documented failure to obtain and maintain
required medical equipment will result in a loss of 3 percentage points from
the final semester grade.
Core Competencies
II. Medical Knowledge
By the conclusion of Clinical Examination Semester III, students will demonstrate
the ability to:
These will be evaluated via written tests, feedback during skills sessions, SP
feedback following a FEW, and the OSCE.
III. Patient Care (Problem Solving and Clinical Skills)
By the conclusion of Clinical Examination Semester III, students will demonstrate
the ability to:
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Schedule
Block 1
Cardiac Skills
Heart (Chapter 14)
12-Lead ECG, The Art of Interpretation (to include the Basic and
Intermediate Levels, but not the Advanced level sections)
Learning Objectives:
1. Describe anatomy and physiology of the organ system
2. Identify anatomical landmarks that are significant in a physical
examination of the organ system
3. Identify normal age variations found on examination of the organ
system
4. Identify and explain the significance of abnormal physical findings
5. Recognize findings that deviate from expected findings
6. Relate symptoms or clinical findings to common pathologic conditions of
the organ system
7. Demonstrate the ability to use common medical equipment
8. Demonstrate examination techniques for the organ system
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Block 2
Abdomen Skills
Abdomen (Chapter 17)
Female Genitalia
Female Genitalia (Chapter 18)
Breasts and Axillae
Breast and Axillae (Chapter 16)
Male Genitalia
Male Genitalia (Chapter 19)
Anus, Rectum, and Prostate
Anus, Rectum, and Prostate (Chapter 20)
Learning Objectives:
1. Describe anatomy and physiology of the organ system
2. Identify anatomical landmarks that are significant in a physical
examination of the organ system
3. Identify normal age variations found on examination of the organ
system
4. Identify and explain the significance of abnormal physical findings
5. Recognize findings that deviate from expected findings
6. Relate symptoms or clinical findings to common pathologic conditions of
the organ system
7. Demonstrate the ability to use common medical equipment
8. Demonstrate examination techniques for the organ system