NDLI: Core and cluster or head to toe?: a comparison of two types of curricula for teaching physical examination skills to preclinical medical students

Content Provider	Springer Nature : BioMed Central
Author	Jewett, LilyAnne Clarke, Samuel Griffin, Erin Danielson, Aaron
Abstract	Background Despite the central importance of physical examination (PE) skills to patient evaluation, early trainees struggle with its correct application and interpretation. This struggle may reflect the instructional strategies of PE courses which have largely ignored the clinical reasoning necessary to accurately apply these skills. The “core + cluster” (C + C) is a recent approach to teaching PE to clerkship-level medical students that combines a basic ‘core’ exam with ‘cluster’ based on the student’s hypothesis about their patient’s clinical presentation. Our institution developed a novel C + C curriculum to teach PE to preclinical students. We aimed to assess the impact of this new curriculum on students’ clinical skills and course evaluations in comparison to the traditional “head-to-toe” approach we’d used previously. Methods This was a retrospective study comparing two consecutive medical school cohorts exposed to the new (C + C) and prior (HTT) curricula respectively. We studied two complete cohorts of first-year medical students at our institution who matriculated in 2014 and 2015. The 2014 cohort received PE training via an HTT approach. The 2015 cohort received PE training via a C + C approach. Outcomes included performance scores on a statewide clinical performance exam (CPX) and student course evaluations. Results We found no statistically significant difference in mean CPX scores between the two cohorts. However, student course ratings were significantly higher in the C + C cohort and students rated the C + C format as highly useful in clinical encounters. Conclusions The C + C curriculum appears to be as effective a method of teaching PE to preclinical students as the HTT approach and is better received by students. We believe that this approach more appropriately reflects the way PE is used in clinical encounters and may help students with diagnostic hypothesis generation.
Related Links	https://bmcmededuc.biomedcentral.com/counter/pdf/10.1186/s12909-024-05191-x.pdf
Ending Page	7
Page Count	7
Starting Page	1
File Format	HTM / HTML
ISSN	14726920
DOI	10.1186/s12909-024-05191-x
Journal	BMC Medical Education
Issue Number	1
Volume Number	24
Language	English
Publisher	BioMed Central
Publisher Date	2024-03-26
Access Restriction	Open
Subject Keyword	Medical Education Theory of Medicine Bioethics Physical examination Medical students Curriculum design Theory of Medicine/Bioethics
Content Type	Text
Resource Type	Article
Subject	Education Medicine
Journal Impact Factor	2.7/2023
5-Year Journal Impact Factor	3.4/2023

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1	Ministry of Education (GoI), Department of Higher Education	Sanctioning Authority	https://www.education.gov.in/ict-initiatives
2	Indian Institute of Technology Kharagpur	Host Institute of the Project: The host institute of the project is responsible for providing infrastructure support and hosting the project	https://www.iitkgp.ac.in
3	National Digital Library of India Office, Indian Institute of Technology Kharagpur	The administrative and infrastructural headquarters of the project	Dr. B. Sutradhar bsutra@ndl.gov.in
4	Project PI / Joint PI	Principal Investigator and Joint Principal Investigators of the project	Dr. B. Sutradhar bsutra@ndl.gov.in Prof. Saswat Chakrabarti will be added soon
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9	IDR Setup or Support	Queries related to establishment and support of Institutional Digital Repository (IDR) and IDR workshops	idr@ndl.gov.in

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