Table 2.
Mean Self-Confidence in Individual Physical Examination Skills by Training Level
| Physical examination skill | All responders | M3 | M4 | PGY-1 | PGY-2–4 | Faculty Internists |
|---|---|---|---|---|---|---|
| Overall self-confidence in physical examination skills | 3.6 [0.7]* | 3.3 [0.7] | 3.8 [0.6] | 3.4 [0.5] | 3.7 [0.6] | 3.9 [0.7] |
| Measuring blood pressure | 4.7 [0.6] | 4.4 (1)† [0.7] | 4.8 (1) [0.5] | 4.4 (1) [0.7] | 4.7 (1) [0.5] | 4.9 (1) [0.2] |
| Detecting clubbing | 4.2 [0.9] | 3.9 (2) [1.1] | 4.3 (2) [0.8] | 4.2 (2) [0.8] | 4.3 (2) [0.8] | 4.5 (2) [0.8] |
| Detecting ascites | 3.9 [0.8] | 3.8 (3) [0.9] | 4.1 (4) [0.7] | 3.7 (3) [0.8] | 3.9 (4) [0.8] | 3.8 (8) [0.7] |
| Detecting a positive straight-leg raise sign | 3.9 [1.0] | 3.6 (4) [1.2] | 4.3 (3) [0.9] | 3.4 (6) [1.0] | 3.9 (4) [0.7] | 4.3 (3) [0.6] |
| Interpreting a systolic murmur | 3.6 [0.8] | 3.3 (5) [0.9] | 3.6 (6) [0.9] | 3.5 (4) [0.6] | 3.9 (4) [0.7] | 3.9 (6) [0.9] |
| Detecting a pleural effusion | 3.5 [0.9] | 3.1 (7) [1.0] | 3.4 (8) [0.9] | 3.3 (7) [0.9] | 3.9 (4) [0.7] | 4.0 (4) [0.8] |
| Determining vertical liver span | 3.5 [1.0] | 3.2 (6) [1.1] | 3.3 (10) [0.9] | 3.3 (7) [1.0] | 3.7 (7) [0.9] | 4.0 (4) [0.8] |
| Detecting a breast mass in a female patient | 3.4 [0.9] | 2.9 (9) [1.0] | 3.7 (5) [0.9] | 3.1 (9) [0.9] | 3.4 (8) [0.8] | 3.9 (6) [0.8] |
| Detecting splenomegaly | 3.2 [0.9] | 3.0 (8) [1.0] | 3.5 (7) [0.9] | 2.8 (11) [0.8] | 3.3 (9) [0.8] | 3.7 (10) [0.8] |
| Distinguishing between a mole and melanoma | 3.2 [1.0] | 2.8 (10) [1.1] | 3.4 (8) [1.0] | 3.5 (4) [0.9] | 3.3 (9) [0.9] | 3.5 (11) [0.9] |
| Measuring jugular venous pressure | 3.0 [1.0] | 2.7 (12) [1.0] | 2.8 (12) [1.1] | 2.8 (10) [0.9] | 3.0 (11) [0.9] | 3.8 (8) [0.8] |
| Interpreting a diastolic murmur | 2.9 [0.9] | 2.8 (10) [1.0] | 2.8 (12) [1.0] | 2.5 (11) [0.8] | 3.0 (11) [0.8] | 3.4 (12) [0.9] |
| Detecting a thyroid nodule | 2.8 [0.9] | 2.5 (13) [1.0] | 3.1 (11) [0.9] | 2.5 (11) [0.9] | 2.9 (13) [0.7] | 3.4 (12) [0.8] |
| Nondilated fundoscopic examination using an ophthalmoscope to assess retinal vasculature | 2.5 [1.1] | 2.3 (14) [1.1] | 2.8 (12) [1.2] | 2.3 (14) [1.1] | 2.2 (14) [1.0] | 3.2 (14) [1.1] |
Self-confidence scale: 1 = “Not at all Confident”; 3 = “Neutral”; 5 = “Very Confident”
*Standard deviation is in brackets
†Relative ranking of self-confidence for each physical examination skill within each group is in parentheses