Table 4.
Mean Perceived Utility of Individual Physical Examination Skills by Training Level
| Physical examination skill | All responders | M3 | M4 | PGY-1 | PGY-2–4 | Faculty Internists |
|---|---|---|---|---|---|---|
| Overall perceived utility of physical examination skills | 4.2 [0.7]* | 4.4 [0.7] | 4.4 [0.5] | 3.9 [0.8] | 4.0 [0.7] | 4.1 [0.7] |
| Measuring blood pressure | 4.9 [0.3] | 4.8 (1)† [0.4] | 4.9 (1) [0.3] | 4.8 (1) [0.4] | 4.9 (1) [0.4] | 4.9 (1) [0.2] |
| Distinguishing between a mole and melanoma | 4.7 [0.6] | 4.7 (2) [0.6] | 4.8 (2) [0.5] | 4.7 (2) [0.6] | 4.6 (2) [0.6] | 4.7 (2) [0.5] |
| Detecting a breast mass in a female patient | 4.6 [0.6] | 4.5 (3) [0.7] | 4.6 (3) [0.6] | 4.5 (3) [0.6] | 4.5 (3) [0.6] | 4.7 (2) [0.5] |
| Detecting a pleural effusion | 4.3 [0.7] | 4.4 (4) [0.7] | 4.5 (5) [0.6] | 4.0 (6) [0.8] | 4.3 (4) [0.7] | 4.2 (5) [0.9] |
| Detecting ascites | 4.3 [0.8] | 4.3 (5) [0.6] | 4.6 (3) [0.5] | 4.1 (4) [0.8] | 4.2 (6) [0.9] | 4.2 (5) [0.8] |
| Detecting a thyroid nodule | 4.2 [0.8] | 4.2 (7) [0.8] | 4.4 (6) [0.7] | 3.9 (9) [0.8] | 4.2 (6) [0.7] | 4.2 (5) [0.6] |
| Interpreting a systolic murmur | 4.2 [0.7] | 4.3 (5) [0.8] | 4.2 (9) [0.7] | 4.0 (6) [0.8] | 4.2 (6) [0.7] | 4.1 (8) [0.7] |
| Interpreting a diastolic murmur | 4.2 [0.8] | 4.2 (7) [0.8] | 4.3 (8) [0.8] | 4.0 (6) [0.8] | 4.2 (6) [0.8] | 4.1 (8) [0.8] |
| Detecting splenomegaly | 4.1 [0.8] | 4.1 (9) [0.8] | 4.4 (6) [0.6] | 3.8 (10) [0.7] | 4.1 (10) [0.7] | 4.3 (4) [0.8] |
| Measuring jugular venous pressure | 4.0 [0.9] | 3.9 (10) [1.0] | 3.9 (11) [0.8] | 4.1 (4) [0.6] | 4.3 (4) [0.8] | 3.9 (10) [0.9] |
| Detecting a positive straight-leg raise sign | 3.8 [0.9] | 3.8 (11) [0.9] | 4.0 (10) [0.9] | 3.6 (12) [0.9] | 3.6 (13) [0.9] | 3.6 (12) [0.9] |
| Nondilated fundoscopic examination using an ophthalmoscope to assess retinal vasculature | 3.7 [0.9] | 3.8 (11) [1.0] | 3.7 (13) [1.0] | 3.7 (11) [0.9] | 3.8 (11) [0.9] | 3.5 (14) [0.8] |
| Determining vertical liver span | 3.7 [0.9] | 3.6 (13) [1.1] | 3.8 (12) [0.9] | 3.5 (13) [0.9] | 3.8 (11) [0.8] | 3.6 (12) [0.8] |
| Detecting clubbing | 3.5 [1.1] | 3.5 (14) [1.1] | 3.6 (14) [1.0] | 3.1 (14) [1.1] | 3.5 (14) [1.1] | 3.7 (11) [1.0] |
Perceived utility scale: 1 = “Not at all Useful”; 3 = “Neutral”; 5 = “Very Useful”
*Standard deviation is in brackets
†Relative ranking of perceived utility for each physical examination skill within each group is in parentheses