Evidence-Based Physical Finding Rounds

For those of you with a particular interest in physical exam skills (or those of you who are already becoming skeptical about the utility of physical examinations), you may want to consider researching the sensitivity and specificity of a particular physical exam technique in diagnosing a disease. (e.g How accurate is the physical examination in detecting congestive heart failure?) The ideal way to do this is to research something relevant to one of your patients and present the findings and what your research showed during physical finding rounds. Our chief residents and hospitalists who lead these rounds will be happy to let you lead all or part of the rounds.

JAMA has been publishing articles for many years that address these questions under the heading of The Rational Clinical Exam. This is a great starting point. I also have a book by Steve McGee called Evidence-Based Physical Diagnosis that I would be happy to loan you.

The Format

The format should basically be the same as other EBM projects:

  1. the question
  2. the article(s) selected
  3. brief discussion of the article and review of proper physical exam technique that is relevant
  4. recommended application to patient care.